
Qass_ 
Book_ 



COPYRIGHT DEPOSIT 




iiy special permission of Owen Zimmerman, Photograj 



THE MOTHER AND HER FIRST-BORN. 

What is so attractive as a young and beautiful mother with her babe t 
"A mother is a mother still, ike }coliest thing alive. :} 



HYGIENE TOCOLOGY PEDIATRICS 



LIFE KNOWLEDGE 



■OR 



WOMAN'S RESPONSIBILITIES AND 
DUTIES AT ALL PERIODS OF LIFE 

— A GUIDE 



IN THE MAINTENANCE OF HER OWN 
HEALTH AND THAT OF HER CHILDREN 



— BY— 

MYER SOLIS-COHEN, A.B., M.D. 

Instructor in Physical Diagnosis, University of Pennsylvania; Visiting Physi- 
cian to the Hospital for Diseases of the Lungs, Chestnut Hill; Assistant 
Physican to the Philadelphia General Hospital; Physican to the Children's 
Dispensary of the Jewish Hospital, Philadelphia. 

PROFUSELY ILLUSTRATED WITH COLOR PLATES 
SCIENTIFIC DRAWINGS AND HALF-TONE ENGRAVINGS 



MANIKIN CHART 

Printed in Colors, with an Index 



UPLIFT PUBLISHING COMPANY 

PHILADELPHIA 






' 



Copys'igtit, 1909 
By W. E. Scuii 

Entered according to act of Congress in the 
year 1906 by W. E. SCULL, in the office 
of the Librarian of Congress, at Washington, 
D. C. Woman: In Girlhood, Wifehood, 
and Motherhood. 

All Rights Reserved 



LIBRARY of CONGRESS 
Two Codes Received 

APR 16 180$ 

Copy meat tntry 
CEASS «_ KXC, No, 

"2-3> Q, § 53 

CCr- :■ 




PREFACE AND INTRODUCTION 



I 



|T is remarkable in this age of higher education for 
women that instruction concerning so many im- 
ggBa ) portant things in a woman's life should be practically 
neglected, and, as a rule, left to chance. Through 
ignorance of Nature's hygienic laws a woman often loses 
not only her health, but 
also the beauty that is & 

dependent upon it. 

The young mother 
commits many grave er- 
rors when caring for her 
baby by too often rely- 
ing solely upon her in- 
tuition, or upon the ad- 
vice of ignorant friends. 
Many parents neglect to 
give their children the 
information and advice 
needed at the period of 
adolescence because, not 
possessing full knowl- 
edge as to the phenom- 
ena of such a time and 
not realizing the dan- 
gers of silence, they feel 
diffident and embar- 
rassed about referring 
to the s u b j e c t. All 
through her life, from infancy to old age, a woman fre- 
quently suffers from conditions which she might have 
avoided had she been properly informed as to the rules of 

iii 




Thi Mother and Her Baby. 



PREFACE AND INTRODUCTION 

health. Yet each woman must solve the hygienic problems 
of clothing, food and bathing, the ventilation of the home, 
and the physical, mental and moral training of the children. 

It is to supply the information that keeps a woman 
well and happy and guides her in bringing up a family 
strong in body, in mind and in morals, that this book has 
been written. 

The proper person to instruct a woman in many of 
these matters no doubt is her family physician. But the 
busy practitioner seldom can take the time to discuss the 
details of right living and explain how disease is to be pre- 
vented. These things he, too, leaves to chance. In fact, 
the doctor is seldom consulted except to treat some one who 
is sick, and then must spend his whole time in getting the 
patient well. After she has allowed the doctor to depart, 
how often does the young mother or the sick girl recollect 
something about which she had neglected to ask advice! 

Thus it happens that for directions about the details 
of her life, when sick and well, a woman must rely upon 
an accurate book which she can consult at all times. Un- 
fortunately, many of the books sold as health guides for 
women are unreliable and of a doubtful character. Pre- 
tending to be physiological, they are in reality prurient and 
suggestive, and cater to a depraved taste. In this book 
the endeavor is made to give all the information a woman 
requires for any of the emergencies that may occur during 
her own life and for the preservation of health and beauty. 

The author has used simple language throughout, 
avoiding technical terms, and has endeavored to make the 
statements so plain and clear as to be easily understood by 
every one. At the same time he has written only what is 
in accordance with the latest scientific knowledge. More- 
over, in giving advice, he has avoided generalities and has 
made his directions pointed and definite. 

iv 



PREFACE AND INTRODUCTION 

The first part of the book treats of health and beauty, 
telling how both may be preserved and obtained. The care 
of the skin, the complexion, the hair, the teeth and the 
nails, the questions of clothing and dress, food and drink, 
I and exercise and rest, are taken up in detail. The second 
part describes the important periods of a woman's child- 
hood, maidenhood, wifehood and motherhood, giving the 
practical knowledge that prevents disease and promotes 
woman's health and happiness. The management of child- 
birth is then considered, with full directions as regards the 
preparations for the confinement, the labor itself, and the 
care of mother and baby after the latter is born. This is 
followed by "The Baby, and How to Care for It," including 
the bathing, clothing, feeding, exercising, training and 
amusing of the well baby and the management of the sick 
baby. Next come the diseases peculiar to women, the 
causes of which are pointed out, that they may be avoided. 
Prevention is given prominence and methods of treatment 
are described in cases where simple home remedies may be 
applied without harm and in emergencies. 

Great care has been used in the selection of illustra- 
tions, that they be both appropriate and in sufficient num- 
ber to elucidate the text; they have been inserted in the 
form of scientific drawings, photographs and special artists' 
sketches. A manikin, drawn, colored and put together with 
great exactness, and explained with a descriptive key, ac- 
companies each book for the use of those who are interested 
in the study of anatomy. 

Any unavoidable medical or other terms requiring 
elucidation are fully explained in a glossary. 

A complete index has been added, so that anything in 
the book mav be found in a few seconds. 

MYER SOLIS-COHEN. 

41 10 Parkside avenue, Philadelphia. 
1905. 



EXPLANATION OF MANIKIN CHART. 



10. 

IX. 

12. 
13- 
34. 

I5-. 
16. 

17. 
18 

20. 
ax. 
22. 

23- 
24. 

25. 
26. 
27. 
28. 

29. 

30. 
3i. 
32. 

33- 

34. 

35. 

36. 



37. 
38. 

39- 
40. 

41. 



The large breast-muscle. 42. 
The broad muscle of the back. 

The serrated muscle. 43. 

Commencement of the external 44. 

oblique muscle. 45. 

External j musc i es between the ribs. 46 

Seventh rib. 

Twelfth or floating rib. 47- 

Internal oblique muscle, forming 4°. 
a broad thin sheet at the me- 
dian line. 49 
The long thigh muscle. 
Ligament formed by the lower 

end of the long thigh muscle. Si- 

Hip muscle. 52. 

The muscle of the buttocks. 53- 

The fat of the buttocks. 54- 

I^er 16 ) extensor muscles of the 55 * 

Outer ) thi * h ' 
and 19. Flexor muscles of the 56. 

thigh. 
Mammary gland or breast. 
One of the bones of the spine. 57- 

Collar-bone. 

1st rib. 58. 

7th rib. 

12th or floating rib. 59- 

Breast-bone. 

The muscles between the ribs. 60. 

Hip bone. (One of the bones of 

the pelvis). 
Upper front corner of the hip 61. 

bone. 
Upper back corner of the hip bone. 
The socket of the hip. 62. 

Prominence on the bone of the 63. 

buttocks. 
Bone of the buttocks. (One of 

the bones of the pelvis). 64. 

Passageway for blood vessels and 

nerves. 65. 

The bone of the seat. (One of 

the bones of the pelvis). 66. 

The lowest bone, or lower end, of 

the spine. (One of the bones 67. 

of the pelvis). 68. 

Triangularis sternis muscle. 69. 

Beginning of the external oblique 

muscle. 70. 

Diaphragm, which divides the 71. 

chest from the abdomen. (Cut 72. 

through). 7s- 

Upper border of the hip bone. 74. 

(One of the bones of the pel- 75 

vis). 
Concavity on the inner side of the 77. 

Mo bone. 78. 



Ridge of bone forming the lower 
border of the above. 

Junction of the two pubic bones. 

Pubic bone. 

Upper end of the bone of the but- 
tocks. 

Part of the bone of the buttocks 
on which we sit. 

One of the bones of the spine. 

The bone of the seat. (Cut in 
half). (Same as No. 35). 
and 50. Ligaments connecting the 
above with the bone of the but- 
tocks. 

Upper, ) 

Middle, Mobes of the lung. 

Lower, ) 

Bronchial tubes. (Cut across). 

Mammary gland or breast, cut 
through so as to show its struc- 
ture. (Same as No. 20). 

Nipple (cut through), showing 
how all the milk ducts converge 
there. 

Breast bone cut in half. (Same 
as No. 26). 

One of the bones of the spine. 
(Cut in half). 

One of the bones of the spine. 
(Cut in half). 

One of the bones of the spine. 
(Cut in half). (Same as No. 
47). 

The bone of the seat. (Cut in 
half). (Same as Nos. 35 and 
48). 

Muscles of the spine. 

Spine, cut open so as to show the 
spinal cord and the nerves com- 
ing from it. 

The muscle that surrounds and 
closes the anus. (Cut through). 

Trachea or wind-pipe. (Cut 
across). 

Portion of the pleura, or mem- 
brane covering the lungs. 

A portion of the heart. 

Diaphragm. (Same as No. 39) 

Large blood vessel leaving the 
heart. (Cut across). 

Lower branch of the above. 

Duct. (Cut across). 

Membrane covering the liver. 

Liver. (Cut across). 

Stomach. (Cut across), 
and 76. Coils of the large intes- 
tines. (Cut across). 

Rectum. (Cut across). 

Pancreas. 



EXPLANATION OF MANIKIN CHART. 



90. 

91. 
92. 

93. 
94. 
95. 
96. 
97. 
98. 

99. 

IOO. 



101. 



Esophagus or gullet. (Cut 

across). 
Subclavian vein. (Cut across). 
Pulmonary artery. 
Pulmonary artery. (Cut across). 
Large vein entering the heart. 

(Cut across). 
A portion of the heart (cut across 

so as to show one of the cham- 
bers), 
and 86. Vein. (Cut across). 
Artery. (Cut across). 
Uterus or womb at the end of 

pregnancy. 
Cervix or mouth of the womb at 

the end of pregnancy. 
Inner wall of the womb at the 112 

end of pregnancy. 
The child in the womb. 
Placenta or after-birth. 
Vagina. 



Labia minora. 
Labia majora. 
Anus. 
Bladder. 
Abdominal or 
Clitoris. 
Junction of 



belly cavity. 



across). (Same 



(Cut 
43). 

The non-pregnant 
across). 



the pubic bones, 
as No. 



102. 
103. 

104. 

105. 

106. 

107. 

108. 
109. 
no. 
III. 



113- 



uterus. (Cut 



114. 
115. 
116. 
117. 
118. 
119. 
120. 
121. 

122. 



Ovary. 

The round ligament supporting 
the uterus. 

Fimbriated extremity of the ovi- 
duct or fallopian tube 

Membrane dividing the two lobes 
of the great brain or cerebrum. 

Portion of the great brain or cere- 
brum. 

Cerebellum or little brain. (Cut 
across). 

Medulla. 

The uppermost bone of the spine. 

Spinal cord. 

Esophagus or gullet. (Same as 
No. 79). 

The most prominent bone of the 
spine. 

Trachea or wind-pipe. (Same as 
No. 65). 

Cerebrum or great brain. 

Nasal center. 

Roof of mouth or hard palate. 

Soft palate. 

Tongue. 

Chin bone. 

Larynx or speaking box. 

Thyroid gland. (This sometimes 
becomes a goitre). 

Breast bone or sternum. (Same 
as No. 26). 



TABLE OF CONTENTS. 



PART I. 

HEALTH AND BEAUTY. 



PAGS 

PREFACE AND INTRODUCTION 5 

CHAPTER I. 

THE BASIS OF BEAUTY. 

Standards of Beauty: According to Voltaire; among different ages and 
among different peoples; with the cultivated — Modern Ideas of Beauty: 
Symmetry, proportion, curves, color, gradation — Human beauty not 
complete without expression — Youth not necessary to beauty — Health 
an essential — How every woman can acquire, increase or retain beauty — 
The perfect woman 25 

CHAPTER II. 

BATHING AS A MEANS OF HEALTH AND BEAUTY. 

The structure of the skin — The cleansing bath — The cold, or hygienic, or hard- 
ening bath — How one catches cold — The action of the cold bath — How 
to promote the reaction — Forms of the cold bath: The cold full tub bath; 
The cold half-bath; The cold sponge bath; The cold shower or douche 
bath — The reaction after a cold bath — Several directions for cold bathing 
— The hardening effect of cold bathing — The Turkish bath — Sea ba tiling 
— The care of the complexion — Care of the ears — Facial massage — The 
use of cold cream — Powders — General hygienic measures -The pre- 
vention of wrinkles and their removal 33 

(ix) 



x CONTENTS 

CHAPTER III. 
THE CARE OF THE TEETH, THE NAILS AND THE HAIR. 

PAGE 

Perfect teeth necessary from the standpoint of health as well as beauty — How 
to preserve the teeth: Powder, brush, mouthwash — Cleansing and mani- 
curing the nails. — The structure of the hair — How to care for the hair: 
Brushing, combing, shampooing, massage, curling the hair — Decora- 
tions for the hair — Hints on hair dressing 44 

CHAPTER IV. 
THE FIGURE— HOW TO DEVELOP A GRACEFUL CARRIAGE. 

Standard of beauty in the figure — The prevention of deformities — How 
deformities are acquired — School a factor in producing deformities — How 
to detect deformities — Mechanical means to prevent deformities — How 
to improve the figure — The correct standing position — The position 
to be assumed when sitting — The proper method of walking — Exercises 
for developing a graceful carriage — How to utilize housework in develop- 
ing the figure — Exercises for developing the figure 51 

CHAPTER V. 
CLOTHING FROM THE HYGIENIC AND ARTISTIC STANDPOINT. 

The Hygiene of undergarments — The material that best preserves heat — The 
best absorbent of moisture — The best material for underwear — Stockings 
— Outer Garments : Materials for various conditions — The influence of 
color — Constriction to be avoided — Shoes — Beauty in dress — The colors 
that may be worn by the different types 64 



CHAPTER VI. 

FOOD AND DRINK. 

The hours for meals — Taking sufficient time to eat — Rest after meals — The 
different kinds of food and how to prepare them — Animal foods — Milk 



CONTENTS xi 

PAGE 

and milk products — Eggs raw and cooked in various ways — Meats and 
how to prepare them — Fish and shell-fish — The relative digestibility of 
different animal foods. — Vegetable Foods: Sugars, cereals, roots and 
tubers, green vegetables — Fruits — The different beverages: Drinking 
water; coffee; tea; cocoa and chocolate; alcoholic drinks 73 



CHAPTER VII. 
WORK, REST AND RECREATION. 

Work in its relation to health — Child labor — The length of the working day — 
The necessity for rest — The noon hour — The ability to relax — The weekly 
and yearly vacation — The hygiene of sleep — Amount of sleep required — 
The bed and the bed-clothes — The way to lie — The bed-room — Rules for 
sleeping — The necessity for recreation — Mental recreation — Physical 
recreation: Walking, running, climbing, bicycling, horseback riding, 
rowing, canoeing, swimming, lawn tennis, tether tennis, golf, basket 
ball, bowling, fencing, punching the bag, dancing 83 



PART II. 
A WOMAN'S LIFE. 



CHAPTER VIII. 
ANATOMY AND PHYSIOLOGY. 

Sex Throughout Nature: In plants; in the lower animals; in man. Woman's 
physical characteristics — The female sexual organs: In plants; in the 
lower animals; in woman. Woman's reproductive organs: The womb. 
the fallopian tubes — The ovaries — The pelvis 0; 



xii CONTENTS 

CHAPTER IX. 

THE PERIOD OF PUBERTY : PASSING FROM CHILDHOOD TO 

WOMANHOOD. 

PAGE 

The changes that occur at adolescence — Variations in the age of puberty due 
to climate, race, mode of life and heredity — Delay in the appearance of 
the chief sign of puberty — The mental changes at puberty — The reli- 
gious changes — The mother's duty — The hygiene of puberty ioo 



CHAPTER X. 

THE MONTHLY PHENOMENA. 

Ovulation — Menstruation — Time of onset and cessation — Character of the 
menstrual discharge — Duration of the flow — Quantity of the discharge — 
Other symptoms exhibited at this period — The menstrual interval — 
Pain during menstruation — Connection between menstruation and ovula- 
tion — Vicarious menstruation — The hygiene of the menstrual period. ... 106 



CHAPTER XL 

PURITY. 

The danger of silence — A mother's responsibility — What constitutes purity — 
A mother's duty to her daughter — To preserve true modesty and inno- 
cence — Secret vice — Hygiene as a prevention and treatment 1 1 1 



CHAPTER XII. 

MARRIAGE AND COURTSHIP. 

The views of various thinkers — The origin of marriage and the family — Mar- 
riage customs among different people — Courtship according to modern 
ideas: In continental Europe, in England, in America — Love the basis 
for marriage — The nature of love, according to the poet and the philoso- 
pher — Passion versus affection — Love as a passion is transient — Passion 
may be followed by a steadier sentiment — Marriages based on passion 
are unhappy — Province of courtship to cultivate mutual esteem and 



CONTENTS xiii 

PAGE 

friendship — The money question should be considered before marriage — 
A wrong standard of requirements — Marriage for position or wealth — 
Sincerity during courtship — The training of a girl for wifehood — Quali- 
ties needed by a workingman's wife — The proper age for marrying — 
The danger of early marriages — A mutual understanding about details 
necessary before marriage 1 1 6 



CHAPTER XIII. 
HEREDITY IN ITS RELATION TO MARRIAGE. CONSANGUINITY. 

Providing for the health of the unborn — Exchange of confidences — A physi- 
cian should be consulted — When these precautions are disregarded — 
Where the hereditary taint is slight — Drunkenness an obstacle to marriage 
— Insanity and epilepsy a bar to marriage — Deaf-mutism in its relation to 
marriage — Instinctive criminality a form of degeneracy — Consumption 
a disease in which heredity is sometimes a factor — The marriage of syphi- 
litics — Consanguineous marriages 132 



CHAPTER XIV. 

THE BASIS OF HAPPINESS IN MARRIED LIFE. 

Love is kept by art — The influence of the personal appearance — Care in the 
personal appearance — Dressing for the world rather than for the home — 
The invasion of the home by conventionalities — The husband neglected 
for the children — The avoidance of contention — The economic depend- 
ency of woman — Humiliation dwarfs a woman's character — The question 
of pocket money — Race suicide — Healthy home life necessary 140 



CHAPTER XV. 

PREGNANCY: THE DEVELOPMENT OF THE CHILD. 

An explanation of Nature's mysteries — Reproduction: In plants; in the 
lower animals; in man. — Conception — The development and nourish- 
ment of the embryo or unborn child — The placenta and umbilical cord — 
Changes in the mother during pregnancy — Lightening 150 



xiv CONTENTS 

CHAPTER XVI. 
THE SYMPTOMS OF PREGNANCY. 

PAGE 

Determination of the existence of pregnancy — The commonest symptoms of 
pregnancy: The cessation of menstruation; Morning sickness; Appear- 
ance of the face; Changes in the breasts; Changes in the size, shape and 
appearance of the abdomen — Quickening: Alterations in the nervous 
system — Change in color of the mucous membrane — Hearing the fetal 
sounds — The physician's examination 156 



CHAPTER XVII. 

THE LIFE OF A WOMAN DURING PREGNANCY. 

Diet — Dress : hygienic or maternity waists and corsets ; the abdominal band- 
age — Exercises to strengthen the muscles and preserve the figure — Bath- 
ing during pregnancy — Work, exercise and rest — Maternal impressions — 
Keeping the mind in pleasant channels — How to render labor easy — 
Care of the breasts during pregnancy — Preparation of the nipples — Care 
of excretions and discharges : The urine ; the bowels ; leucorrhea — Marital 
relations during pregnancy 161 



CHAPTER XVIII. 

THE MENOPAUSE—" CHANGE OF LIFE." 

Age at which "change of life" occurs — Method of oncoming — Symptoms of the 
menopause: Headache, flushes of heat, derangement of the digestive 
and nervous systems — A mistake to attribute all symptoms at middle- 
life to the menopause — The physiology of the menopause — Importance 
of familiarity with the normal phenomena — The recognition of danger 
signals — Hygiene of the menopause 167 



CONTENTS xv 

PART III. 

CHILD-BIRTH. 



CHAPTER XIX. 
PREPARATIONS FOR THE CONFINEMENT. 

PAGE 

Have the best, if possible; if not, have the best possible tinder the circum- 
stances — The lying-in room — Arrangement of the bed — Things needed for 
the confinement: Absorbent pads, occulsive bandages or napkins, the 
abdominal binder, the baby's basket, the baby's clothes, etc. — Prepara- 
tion of the patient — Engaging the physician and nurse — The Accoucheur: 
Physcian vs. midwife — The nurse: Trained nurse vs. monthly nurse — 
Selection of a nurse ; her duties 175 



CHAPTER XX. 
THE PHYSIOLOGY OF CHILD-BIRTH. 

Causes of labor — How to calculate the day of confinement — The duration of 
pregnancy — Methods of calculation — Importance of knowing the date 
of the last menstruation — Child-birth : The first stage of labor ; the second 
stage ; the third stage — The Puerperium — The lochia 's amount and odor — 
The danger signals — Afterpains — Changes in the breasts 185 

CHAPTER XXI. 
THE MANAGEMENT OF LABOR. 

The knowledge required to make a woman helpful in the lying-in room — The 
Diagnosis of Labor: "Dropping", labor pains, the show — Duration 
of labor — Surgical cleanliness the guiding factor throughout the labor — 
A Talk on germs — How the birth-canal becomes infected — Puerperal 
infection can always be prevented — How to prevent puerperal infection 
— Th» management of the first stage of labor — Diet during the first stage — 



xvi CONTENTS 

PAOB 

The administration of an anesthetic — The management of the second stage 
— Care of a premature infant — Treatment of an asphyxiated baby — Care 
of the mother during the third stage 196 



CHAPTER XXII. 

THE CARE OF THE MOTHER AFTER LABOR. 

The prevention of infection — Rest and quiet — The position to be assumed in 
bed — Getting up — Visitors — Diet for a nursing mother — Bathing — 
Urination — The bowels — Care of the breast and nipples — The mammary 
binder — General hygienic measures — The treatment of distended breasts. 209 



PART IV. 
THE BABY 



CHAPTER XXIII. 

APPEARANCE AND DEVELOPMENT OF THE NORMAL INFANT. 

Color and appearance of the skin— Shape and development of the head; the 
fontanelles— The face at birth— The baby's hair— An infant's tongue — 
The baby's gums— Cutting the Teeth : The first or milk teeth; the second 
or permanent teeth; teething a normal process. — The shape of an infant 
at birth— Position assumed by the baby— The infant's size and weight at 
different ages— The baby's bowels— The baby's urination — The other 
functions of the baby 2I 9 



CONTENTS xvii 

CHAPTER XXIV. 
THE FEEDING OF INFANTS. BREAST-FEEDING. 

PAGE 

Mother's milk the best food for the baby — The baby's thirst — Composition of 
human milk — How to modify breast milk — Conditions affecting the milk 
— Rules for nursing the baby — Feeding during the first few days of life; 
regularity in feeding; frequency of feeding; how long to nurse; how 
the baby should be held — Mixed feeding — The wet-nurse; choice of 
the wet-nurse — Weaning the child ; indications for weaning in the child ; 
in the mother — Methods of weaning — The time for weaning 228 



CHAPTER XXV. 

THE FEEDING OF INFANTS. ARTIFICIAL FEEDING. 

High mortality due to artificial feeding — Difficulty of providing a proper 
substitute for human milk — Substitutes for mother's milk — Composition 
of cow's milk — Modified cow's milk — The percentage modification of cow's 
milk — Milk laboratories — Home modification of cow's milk — Care and 
selection of the ingredients — Preparation of the baby's food — Steriliza- 
tion and pasteurization — Mixtures for average infants at different ages — 
Frequency of feeding — Selection of bottle and nipple — Heating the food — 
How to give the child the bottle — Care of the bottles and nipples — Pep- 
tonized milk — Condensed milk — Patent and proprietary foods — The 
feeding of older children 241 



CHAPTER XXVI. 

BATHING THE BABY. 

Articles required — Temperature of the water — Hour for the bath — The 
best place — How to wash the baby — How to hold it — Pat the baby 
dry, then rub — Care of the hair and ^calp — Care of the gums and 
teeth — Cleansing after bowel movements — Powders ^0. 



xviu CONTENTS 

CHAPTER XXVII. 
CLOTHING FOR THE INFANT AND THE CHILD. 

PAGI 

Dressing the Infant — Character of the Infant's clothes — The baby's binder — 
The diapers — The infant's shirt, petticoat, dress, socks, nightclothes and 
other garments — The Baby in Short Clothes: Stockings, drawers, diaper- 
supporters, foot-gear, bibs, creeping aprons, outing clothes, night slip, 
wrapper — Children's Clothing: Underwear, outer garments, shoes, cloth- 
ing for out-of-doors, night attire 267 



CHAPTER XXVIII. 

THE BABY'S SLEEPING HOURS. 

Amount of sleep required — Regularity in sleeping hours — Baby's position 
when sleeping — Time for sleeping — Preparing baby for bed — The awaken- 
ing in the morning — Ventilating the baby's sleeping room — The Baby's 
Bed: Bassinet, cradle, crib, clothes-basket — How to make the baby's 
bed — How to keep on the covers — Care of the bed — Keeping the air of 
the sleeping-room pure 274 

CHAPTER XXIX. 

EXERCISING AND AMUSING THE BABY. 

Exercising the Baby: The infant's first airing — The proper method of holding 
a new-born infant — Taking the baby out — How to carry an older baby — 
The baby's first exercise — When the baby can hold its head up unsup- 
ported — After the child can stand and walk — Amusing the Baby: Toys 
for baby and child — How to make playthings at home — Games that 
\>oth exercise and amuse the child 283 

CHAPTER XXX. 

MENTAL AND MORAL TRAINING. 

The moulding of character lies in the mother's hands — The control of the 
bladder and bowels — How to deal with children — A child's sensitiveness 
— Children's questions — Kindness and gentleness — A child requires pleas- 



CONTENTS xix 

PAGE 

tire — Politeness — Children's fears — The child a great imitator — How 
children learn conduct — Practice vs. precept — Making a child truthful — 
Children's imagination and temper — Obedience and how to enforce it — 
The spoiled child — Threats and punishment — Order and neatness — 
Learning to talk — The use of money — Children's pets — Stories told to 
children — Children in the society of their elders : Before company ; at the 
table — Education: Kindergarten, school — The training of backward and 
mentally deficient children 292 



CHAPTER XXXI. 

WHEN THE BABY GETS SICK. 

How to Tell When a Baby is 111: Its cry, cough, position, movements and 
gestures; grinding the teeth, difficulty in suckling; appearance of the 
face and head, chest, abdomen and tongue — The baby's temperature — 
How to take the temperature — The pulse in sick children — The breath- 
ing — The baby's bowel movements — The Management of Sick Children: 
Selection of the sick-room; ventilation, heating — The bed; articles needed 
in the sick-room; cleansing of the sick-room — The care of the patient — 
How the child should be dressed in bed — Feeding the sick child — Admin- 
istering medicine to the child — Treating the throat — Administering a 
rectal injection — Attention to the urine 305 



CHAPTER XXXII. 

THE COMMON AFFECTIONS OF INFANCY AND CHILDHOOD. 

The Highly Contagious Diseases: Measles, rubella, scarlet fever, diphtheria, 
membranous croup, small-pox. — The management of a highly contagious 
disease. — Isolation: Preparation of the room; method of disinfecting 
the linen, hands, dishes, vessels, urine and feces; the nurse's attire; care 
of the food; frequent disinfection; disinfecting the mouth and nose; 
convalescence; disinfecting the sick-room; disinfecting the bedding 
and clothing; disinfecting a privy, etc — Care of the body after death — 
Quarantine — The Management of the Mildly Contagious Diseases: Chick- 
en-pox, whooping-cough, typhoid fever, consumption. — The intestinal 
disorders of infancy 323 



xx CONTENTS 



PART V. 

DISEASES PECULIAR TO WOMEN, 



CHAPTER XXXIII 
SYMPTOMS OF WOMAN'S DISEASES AND THEIR TREATMENT. 

PAGB 

Symptoms of Woman's Diseases: How to observe pain; its location, charac- 
ter, degree, duration, frequency, modifications; danger-signals. — Tempo- 
rary Treatment of Pain: Headache, pain in the abdomen, backache — 
Discharges: White or leucorrhea, yellow, bloody; their prevention and 
treatment. — Pruritis or Itching: Its cause and treatment— Constipation : 
Correction without drugs, by habit, exercise and diet 347 



CHAPTER XXXIV. 

DISORDERS OF MENSTRUATION. 

Irregularity — Suppression — Cessation — Pain, during, before, and after the 
period — Flooding — Scanty flow — The sudden arrest of the monthly 
sickness by exposure, etc. — Treatment — Vicarious menstruation 361 



CHAPTER XXXV. 
MISCARRIAGE AND ITS PREVENTION. 

The course of a miscarriage — The causes of a miscarriage — The Signs of a Mis- 
carriage: Pain, hemorrhage, the expulsion of the ovum — The danger of an 
abortion or miscarriage — The prevention of a miscarriage — How to avert it 
when threatened — Treatment of an inevitable miscarriage — Its after treat- 
ment • 367 



3* « 




CONTENTS xxi 

CHAPTER XXXVI. 
STERILITY— ITS CAUSES, PREVENTION AND CURE. 

PAQir 
The woman not always to blame — Causes of Sterility in Women: Abnormali- 
ties, displacements, lacerations, inflammation — General conditions, such 
as obesity, anemia, etc. — Alcoholism — Absence of affinity — Lack of mod- 
eration — Prevention of sterility — The cure of sterility i^z 



CHAPTER XXXVII. 
THE CAUSES OF DISEASES PECULIAR TO WOMAN. 

Neglect of hygienic rules — Lack of proper exercise — Improprieties of dress — 
Improper food — Want of sufficient rest — The development of the mind at 
the expense of the body — Evils in the modern system of education — The 
girl's health given little consideration — Imprudence during menstruation 
— Mismanagement during and after child-birth — Artificial termination 
of pregnancy — Unhygienic marital relations — Chronic constipation — 
The majority of the conditions causing women's diseases are preventable . 377 



CHAPTER XXXVIII. 

THE PREVENTION OF THE DISEASES PECULIAR TO WOMEN. 

The prevention of diseases lies in the woman's hands — When disease has oc- 
curred a physician must always be consulted — The importance of keeping 
the general health at its highest point — Attention must be paid to the man- 
ner of supporting the clothes and to the mode of life generally, especially 
during the period of puberty — Many diseases are prevented by the observ- 
ance of surgical cleanliness during a labor or miscarriage and by the exer- 
cise of prudence and care afterward — The prompt repair of all lacerations 
occurring during child-birth would be the greatest factor in banishing 
invalidism from womankind — The question of personal purity and of 
marrying only one of good moral character -&j 



zxii CONTENTS 

CHAPTER XXXIX 
ACCIDENTS AND EMERGENCIES. 

PAGE 

Foreign Bodies in the Eye ; in the Ear ; in the Nose ; in the Throat — The Effects 
of Heat — Burns and Scalds — The Treatment of Sunburn — Sunstroke or 
Heatstroke — Heat Exhaustion — The Effects of Cold — Freezing and its 
Treatment — Frost Bite — Treatment of Chilblain — The Effects of Injuries — 
The Condition of Shock — Contusion or Bruises — Wounds — Arrest of 
Hemorrhage — Removal of Foreign Bodies from a Wound — Cleansing the 
Wound; Closing and Dressing; Keeping the Part at Rest; Poisoned; by- 
Germs — Stings of Bees, Wasps and Hornets — Snake Bites — Bite of a Mad 
Dog — Sprains, Dislocations, Fractures — The Action of Poisons — Burns 
with Poisons — Drowning 393 



GLOSSARY. 

Explaining the Meaning of the Medical and Other Terms Used in the Book. . 421 



INDEX. 

Complete Index So Arranged that Anything in the Book May be Found at 
Once 441 



PART I. 
HEALTH AND BEAUTY. 






CHAPTER I. 
THE BASIS OF BEAUTY. 



Standards of Beauty: according to Voltaire; among different ages and among 
different peoples; with the cultivated. Modern ideas of Beauty: Symmetry, 
Proportion, Curves, Color, Gradation. Human beauty not complete with- 
out expression. Youth not necessary to beauty. Health an essential. 
How every woman can acquire, increase, or retain beauty. The perfect 
woman. 

"A thing of beauty is a joy forever ; 
Its loveliness increases ; it will never 
Pass into nothingness." 

—Keats. 

BAN'S idea of beauty represents the best of what he 
sees. By observing and comparing all about him he 
finds what pleases him most; this he calls beauty. 
One's standard of beauty will depend largely on 
what one has been accustomed to. Voltaire, the great 
French philosopher, says: "Ask of a toad what is beauty, 
pure beauty, he will answer you that it is his female, with 
two large, round eyes projecting from her little head, a 
large and fat throat, a yellow belly and a brown back. Ask 
the devil, and he will tell you that the beautiful is a pair 
of horns, four claws and a tail." 

Ideas of Beauty in Different Countries. — The senti- 
ments of mankind with regard to female beauty have varied 
with different ages, nations and peoples. A North American 
Indian's ideal of female beauty differs from that of a China- 

25 



26 



THE BASIS OF BEAUTY 



man. It is said that among the ancients a small fore- 
head and joined eyebrows were much admired in a 
woman, and that in Persia to-day large, joined eyebrows 
are highly esteemed. In some parts of Asia, we are told, 
black teeth and white hair are essential to beauty, in 

the Mariana Islands it be- 
ing customary among the 
women to blacken their teeth 
with herbs. Park relates of 
the Moors of Africa that 
with them corpulence and 
beauty are nearly synonym- 
ous terms. The gentle sex 
take great pains to acquire 
this accumulation of fat ear- 
ly in life; for this purpose 
young girls are compelled 
every morning to drink a 
large bowl of camel's milk. 
Appreciation of Real 
Beauty. — It is only the high- 
ly cultivated, however, who 
can appreciate real beauty. 
Ruskin says that no import- 
ance whatever is to be at- 
tached to the opinions of 
races who have never re- 
ceived any ideas of beauty 
whatsoever; that ideas of beauty are only received by minds 
under some certain degree of cultivation. Those who have 
this cultivation do not vary in their views as to beauty, but 
all hold the same opinion. Whatever may be. the difference 
of estimate among unpracticed or uncultivated tastes, there 
will be unity of taste among the experienced; therefore, the 




Beauty and Health. 



THE BASIS OF BEAUTY 27 

result of repeated trial and experience is to arrive at prin- 
ciples of preference in some sort common to all, and which 
are part of our nature. 

THE MODERN IDEA OF BEAUTY. 

According to modern ideas beauty must respond to 
certain tests. Of these, the most important are symmetry, 
proportion, curvature, color and expression. 

By symmetry is meant the balance obtained when two 
parts are placed opposite each other. In animals opposite 
sides are balanced. The two eyes, cheeks and ears, the 
two arms, and so on, are equally distant from the median 
line. This symmetry is less distinct in plant life; but there 
is still a balance maintained between boughs on opposite 
sides of a tree, for instance, and the leaves and sprays on 
each side of the boughs. Flowers, as a rule, have their 
petals symmetrically arranged. The majority of fruits may 
be divided into almost identical halves. Even in the arrange- 
ment of her scenery, Nature follows this plan. The beauty 
of a valley lies in its opposite sides, which rise to equal 
heights; a beautiful stream flows in a winding course, so 
that one turn balances another. 

Proportion is the gradual tapering by which two un- 
equal parts are connected. The tapering of the arm, the 
narrowing at the waist and at the neck, are all instances 
of proportion. This same property is seen in the tree, which 
sends out shorter and smaller branches toward the top. 

Curvature is another important test of beauty. All 
forms of acknowledged beauty, according to Ruskin, are 
composed exclusively of curves. What makes woman, on 
the whole, more beautiful than man is the predominance of 
curves in her outline. According to Professor Kollmann, 
no line on her body is short and sharply angular; they all 
swell, or vault themselves in a gentle curve. The neck 



28 THE BASIS OF BEAUTY 

and rounded shoulders are connected by gracefully curved 
lines, whereas a man's neck is placed more at a right angle 
to the more straight and angular shoulders. All the parts 
are well covered over with adipose tissue and connected 
by those gradual transitions which produce the gently 
rounded outlines; whereas in a man everything — muscles, 
sinews, blood-vessels, bones — is more conspicuous. 

Color and Its Gradations. — Color is generally regarded 
as a less essential ingredient of beauty than form. It is 
said to be the kind of beauty in which the eye takes most 
delight. In "The Spectator'' Addison gives a vivid descrip- 
tion of Nature's use of color in imparting beauty to the 
human face : "Nature has laid out all her art in beautifying 
the face. She has touched it with vermiflion, planted in it 
a double row of ivory, made it the seat of smiles and blushes, 
enlivened it with the brightness of the eye, hung it on each 
side with curious organs of sense, given it airs and graces 
which cannot be described, and surrounded it with such a 
flowing shade of hair as sets its beauties in the most agree- 
able light." 

An important element in color is gradation. Ruskin 
says that what curvature is to lines, gradation is to shades 
and colors. He states that gradation is so inseparably a 
quality of all natural shade and color that the eye refuses 
in art to understand anything in either which appears with- 
out it; while, on the other hand, nearly all the gradations 
of Nature are so subtle and between degrees of tint so 
slightly separated, that no human hand can in any wise 
equal or do anything more than suggest the idea of them. 
He is of the opinion that when the eye is quite uncultivated 
it sees that a man is a man and a face is a face, but has no 
idea what shadows or lights fall upon the face or features. 
If the eye be cultivated to some degree of artistic power, 
it will then see shadows distinctly, but only the more vig- 




II? 



THE BASIS OF BEAUTY 29 

orous of them. Let it be cultivated still further, and it will 
see light within light and shadow within shadow, and will 
continually refuse to rest in what it has already discovered, 
that it may pursue what is more removed and more subtle, 
until at last it comes to give its chief attention and display 
its chief power on gradations which to an untrained faculty 
are partly matters of indifference and partly imperceptible. 
Importance of Expression. — Human beauty is not com- 
plete without expression. Form alone soon ceases to fasci- 
nate. It is expression, ever changing, that lends attraction 
to beauty and sustains one's interest. An index as to the 
mind and character, it has a great part in our estimate of a 
person. In the expression lies the individuality. The in- 
fluence of thoughts and emotions is seen in the face. Ruskin 
tells how the action of the intellectual powers upon the 
features is shown in the fine cutting and chiseling of them. 
The removal from them of signs of sensuality and sloth, by 
which they are blunted and deadened, substitutes energy 
and intensity for vacancy and insipidity. The want of those 
qualities alone has spoiled the faces of many fair women 
and rendered them uninteresting. 

YOUTH NOT NECESSARY TO BEAUTY. 

Youth, although usually associated with beauty, need 
not necessarily accompany it. Helen of Troy, whose beauty 
caused such a long and bloody war, was over forty years 
of age when Paris fell in love with her and carried her 
from her native home. Cleopatra, the famous Egyptian 
charmer, had passed her thirtieth year when she fascinated 
Marc Antony. At forty, Madame Recamier was universally 
regarded as the most beautiful woman in Europe. There 
is a difference, however, in the kind of beauty of the girl 
of sixteen and of the woman of thirty-five. Each age has 
its own type. A woman of advanced years makes herself 



30 THE BASIS OF BEAUTY 

ridiculous when she tries to look youthful; she should en- 
deavor to enhance the mature charms which are proper to 
her age. This will give her a more real beauty. 

BEAUTY DEPENDS UPON HEALTH. 

Ruskin says that if a thing is the result of the complete 
fulfillment of a natural law it will be beautiful; if of the 
violation of a natural law it will be ugly. He considers it 
is easily demonstrable that the pleasure afforded by every 
living form is in proportion to its appearance of healthy 
vital energy. In other words, beauty depends upon health. 

When Health Goes Beauty Fades. — In disease the eye 
loses its lustre, the cheek its bloom; the hair becomes harsh 
and dry, the skin rough. Beauty soon fades when sur- 
rounded by unhygienic conditions. On the other hand, by 
constant attention to the rules of health a woman may de- 
velop a degree of beauty, although without such care she 
might not be in the least attractive. 

What Makes and Mars Beauty. — However shapely the 
hands and nails, without proper care they can never be 
really beautiful. It is the attention paid to the hair that 
gives it the fine and soft appearance so much admired. A 
smooth and clear skin is an indication of health. The figure 
can be greatly improved by attention to position and car- 
riage and by the practice of proper exercises; it may become 
misshapen and deformed by faulty position and by neglect 
of ordinary hygienic rules. Color, which has been shown is 
an important element of beauty, is dependent altogether 
upon the condition of the health. The sallow, the yellow, 
or the pale skin are all indications of disease. Beautiful 
teeth are due to the owner's intelligent care oftener than to 
Nature's gift. Indiscretion in diet and ignorance as to the 
proper kind and amount of exercise necessary may be re- 



THE BASIS OF BEAUTY 31 

sponsible for the existence of fat in some cases and for its 
absence in others. 

How to Preserve Beauty. — Health, without question, 
is the path that leads to beauty. Cosmetics, drugs, and 
other artificial means only lead one astray. Every woman 
has as her birthright a beauty which she can acquire, in- 
crease or keep throughout her lifetime, if only she respect 
and obey Nature's commands and warnings. Yet through 
ignorance she may lose it all. It is one of the purposes of this 
book to point out and explain in a simple yet scientific 
manner the rules of hygiene which must be observed in 
order to obtain and preserve health and beauty, and to 
show how defects due to the non-observance of these rules 
may be corrected. 

With this object in view, chapters have been written 
on bathing and the care of the teeth, nails and hair. The 
proper positions for sitting, standing and walking are given, 
with exercises for developing the figure and acquiring a 
graceful poise. Clothing and food and drink are next con- 
sidered from the hygienic standpoint. This is followed by 
some practical suggestions on the subject of work, rest and 
recreation. 

THE PERFECT WOMAN. 

This study of female beauty has shown that it means 
something more than a pleasing outline; ennobling and en- 
dearing qualities of heart and mind are necessary to it, 
and health is essential. The perfect woman, who combines 
all these qualities, has thus been described by Wordsworth: 



32 THE BASIS OF BEAUTY 

She was a phantom of delight 

When first she gleamed upon my sight; 

A lovely apparition, sent 

To be a moment's ornament. 

Her eyes as stars of twilight fair ; 

Like twilight's, too, her dusky hair ; 

But all things else about her drawn, 

From the Maytime and the cheerful dawn ; 

A dancing shape, an image gay, 

To haunt, to startle and waylay. 



I saw her upon nearer view, 

A spirit, yet a woman, too ! 

Her household motions light and free, 

And steps of virgin liberty; 

A countenance in which did meet 

Sweet records, promises as sweet; 

A creature not too bright or good, 

For human nature's daily food; 

For transient sorrows, simple wiles, 

Praise, blame, love, kisses, tears and smiles. 

And now I see with eye serene, 
The very pulse of the machine ; 
A being breathing thoughtful breath, 
A traveler between life and death. 
The reason firm, the temperate will, 
Endurance, foresight, strength and skill; 
A perfect woman, nobly planned, 
To warn, to comfort and command. 
And yet a spirit still, and bright 
With something of an angel light 



CHAPTER II. 

BATHING AS A MEANS TO HEALTH AND 

BEAUTY. 

The structure of the skin. The cleansing bath. The cold or hygienic or 
hardening bath. How one catches cold. The action of the cold bath. 
How to promote the reaction. Forms of the cold bath: The cold full 
tub bath; the cold half-bath; the cold sponge bath; the cold shower or 
douche bath. The reaction after a cold bath. Directions for cold bath- 
ing. The hardening effect of cold bathing. The Turkish bath. Sea bath- 
ing. The care of the complexion. Care of the ears. Facial massage. The 
use of cold cream. Face powders. General hygienic measures. The pre- 
vention of wrinkles and their removal. Chapped hands. 

"Cleanliness may be defined to be the emblem of purity of mind. ,, 

— Addison. 



HE uses and purposes of the bath are many. Bathing 
is resorted to as a cleansing measure, as a harden- 
ing process which renders a person less liable to 
catch cold, as an exercise, as a hygienic or curative 
procedure, and as a means to beauty. 

THE STRUCTURE OF THE SKIN. 

In order to understand the action of the different kinds 
of baths, and the reasons for their use, one must be familiar 
with the structure of the skin. The skin is composed of two 
layers, an outer thin, horny layer called the cuticle and an 
inner layer which contains blood vessels, glands and nerves, 
and is known as the true skin. A separation of these two 
layers may be seen in the ordinary blister which raises the 
outer skin or cuticle away from the inner skin. The red, 
sensitive surface, which is exposed when the blister bursts, is 
the inner or true skin. 

3 33 



34 



BATHING AS A MEANS TO HEALTH 



The outer skin acts as a protection to the more delicate 
parts beneath. Like all other tissues of the body it is com- 
posed of cells. (See Chapter XV.) New cells are continu- 
ally being formed on the inner surface of this layer, while 
the old cells are being continually thrown off or shed in the 
form of dry, minute scales, appearing as a fine, white dust 
on the body and as dandruff on the head. 

There are no nerves in this outer layer, which conse- 
quently has no sensibility. The epidermis contains the pig- 
ment which gives color to the skin. The different shades 
of color are due to the varying amounts of pigment present. 
The sun's rays stimulate the formation of pigment; the 
races living in the warmer countries have a darker skin than 
those residing in cooler climates; exposure to the sun dur- 
ing the summer months produces tan and freckles in a fair 
skin. 

In the true skin are situ- 
ated muscle fibres which 
have the power of contract- 
ing with cold, and of relax- 
ing with heat. It is the 
former that gives to the skin 
the appearance of goose flesh. 
Running through the skin 
are various small nerves 
which receive sensations of 
touch, pain, heat and cold. 
The skin contains two kinds 

of glands: oil glands and sweat glands. The former are 
found all over the body, being especially abundant on the 
face. They are situated near the roots of the hairs and se- 
crete an oily substance which keeps the skin soft and pliable. 
The sweat glands are also distributed all over the body, lying 
deep in the true skin. From each sweat gland a long, nar- 




Section of the Skin (Magnified), 
Showing the Nerves. 



BATHING AS A MEANS TO HEALTH 



36 



row tube extends up through the skin and conveys the 
sweat to the surface of the body. 





Section of Skin Showing the 
Hairs and Oil Glands. 

(Magnified.) 
7, 8, 9, Oil glands. 
11, Root of hair. 
6, Sheath of hair. 



Section of Skin Showing the 
Sweat Glands and Ducts. 
(Magnified.) 
12, Sweat glands. 
7, 13, 14, Ducts of sweat glands. 



THE CLEANSING BATH. 

It has been shown how the outer skin is constantly 
shedding dead, dry scales, and how the oily glands are de- 
positing grease on the surface of the skin. Both the scales 
and the grease tend to collect on the skin, and with or with- 
out dirt to form a coating which stops up the mouths of 
the tubes from the sweat glands — often spoken of as the 
pores of the skin — thus preventing the proper functions of 
those glands. To remove this accumulation, which may be 
so fine as to be almost unnoticeable, a cleansing bath is 
necessary. 

Warm and temperate baths are best suited to secure 
cleanliness. As water alone cannot dissolve the grease upon 



36 BATHING AS A MEANS TO HEALTH 

the skin, the use of a pure soap is required. Baths should 
not be taken within two hours after a meal. As heat re- 
laxes the blood vessels in the skin and opens the pores, a 
person is liable to take cold after a warm bath unless she 
goes immediately to bed, thus preventing exposure, or else 
takes a cold sponge or shower, followed by a brisk rubbing, 
which restores tone to the blood vessels, thus causing the 
skin to return to its normal condition. 

THE COLD OR HYGIENIC OR HARDENING BATH. 

A cold bath followed by brisk rubbing accustoms the 
blood vessels of the skin to variations of temperature and 
is therefore employed to stimulate the whole system and to 
harden the body against catching cold. 

How One Catches Cold. — To understand the action 
of the hardening bath it is necessary to have some knowledge 
as to how one catches cold. When cold strikes the skin the 
blood vessels in the skin contract and send the blood to the 
internal organs. If the excess of blood remains in the in- 
ternal organs for too long a time, a condition develops which 
we speak of as "cold," characterized by inflammation of the 
nose, throat, or bronchial tubes, and recognized by a cold 
in the head, sore throat, or cough. 

The Action of the Cold Bath.— The object of the cold 
bath is to train the skin to become warm again after having 
been acted upon by cold. 

As stated before, when the cold water comes in con- 
tact with the skin, the blood vessels of the skin contract. 
Later, the time depending upon the reactive ability of the 
individual, these same blood vessels dilate and thus allow 
the circulation in the skin of a greater quantity of blood than 
before. This is called the reaction, which consists in the 
restoration to the skin of the heat that has been abstracted. 
It is the most important element in all cold applications. 




Copyright 



William 11. Rau. 



THE ANGEL MOTHER. 



In the coming of baby life mother life is often sacrificed. Yet 
mother love still hovers around the baby's couch coming fro 
■unseen world to smooth the pillow and to protect her darling. 



BATHING AS A MEANS TO HEALTH 37 

The benefit of the cold bath does not come from the chill 
that the cold water produces, but from this reaction or glow 
or feeling of warmth that follows the bath. 

How to Promote the Reaction. — In a person not ac- 
customed to cold bathing a brisk rubbing for several minutes 
after the bath is usually required to produce this reaction. 
As one becomes accustomed to the cold bath, however, the 
reaction occurs more and more quickly, requiring less and 
less rubbing, until finally it may occur as soon as the cold 
water strikes the body. The reaction is promoted or in- 
creased by the supplying of heat to the body before the bath 
by means of a hot tub or sponge bath or by a brisk rub, by 
active exercise during or after the bath, and by the adminis- 
tration of stimulants either before or after the bath. 

Forms of the Cold Bath.— There are various forms of 
the cold bath, namely: the full tub bath, the half bath, the 
shower bath, and the sponge bath. Everybody is able to take 
a cold bath, but everyone cannot at once, without having 
been accustomed to it, take the same kind of a cold bath. 
Yet all, except the very old, can be trained so as to be able 
to take any form of the cold bath with benefit and without 
discomforts 

The Cold Full Bath.— The cold full bath is also known 
as the plunge or dip. A person merely jumps into a tub 
containing water at a temperature of 72° to 59 Fahrenheit 
and jumps right out again. 

The Cold Half Bath. — In a cold half bath the person 
sits in a tub containing water of a temperature of from 85 ° 
to yo° Fahrenheit which reaches to the level of the navel. 
During the whole time of the bath, which should not last 
longer than one minute, the person rubs the front of her 
body with both hands, while someone else rubs her back 
with one hand and with the other dashes cold water on her 
shoulders. 



38 BATHING AS A MEANS TO HEALTH 

The Cold Sponge Bath. — In the cold sponge bath the 
person may stand directly on the floor or in a foot bath con- 
taining twelve inches of warm water. She then, with a 
sponge or wash cloth, freely applies water of a temperature 
of 65 to 50 Fahrenheit to her arms, chest, back, abdomen, 
legs and thighs. 

The Cold Shower Bath.— In the cold shower bath the 
water issues from a number of perforations called a rose, 
situated a few feet above the person. The chief benefit of 
the shower bath or douche lies in the mechanical stimulation 
of the skin, caused by the force of the water, which pro- 
motes the reaction. The pressure of the water should be 
not less than one atmosphere, that is, fifteen pounds to the 
square inch. When the force is too slight there is no me- 
chanical irritation, but instead a chilling is produced by the 
evaporation of the light spray on the skin. There is, there- 
fore, an objection to taking the douche by means of tubing 
attached to an ordinary faucet unless the required pressure 
can be obtained. In most city houses the pressure in the 
second story is not over ten pounds to the square inch, and 
in the third story it may be only three or four pounds. 

The Reaction After a Cold Bath.— After every kind of 
a cold bath it is essential that a complete reaction take 
place, in other words, that the person become red and warm. 
To accomplish this the body after the bath should be rubbed 
with a rough towel until it glows. Persons not accustomed 
to cold bathing will be able to warm up after a bath if, be- 
fore applying the cold water, they lie for about ten minutes 
in a tub full of water at a temperature of 95° to ioo° Fahren- 
heit, or sponge the body for a minute or two with water of 
the same temperature, or rub the body into a glow. 

General Directions for Cold Bathing.— The best time 
for taking a cold bath is immediately upon rising, while one 
is still warm from the bed. Before the cold bath is taken the 



BATHING AS A MEANS TO HEALTH 39 

face and head should be wet with cold water to prevent the 
blood rushing to the head. If a person feels chilly after the 
bath and does not become warm after brisk rubbing she 
should go to bed until she has reacted, after which she may 
get dressed. There is no danger of taking cold after the 
bath if reaction occurs, as the warm blood coursing through 
the dilated vessels in the skin acts as a protection to the 
body. One can go out into the open air immediately after 
a cold bath that has been followed by a good reaction. 

Persons not used to the cold baths may first employ 
water of a temperature a little higher than that given and 
then gradually reduce it from day to day. It is best to be- 
gin systematic cold bathing in the warmer months. 

The Hardening Effect of Cold Bathing.— The harden- 
ing effect of the cold bath comes from its training the ves- 
sels of the skin to dilate after being contracted by cold, so 
that variations in the temperature and draughts, instead of 
chilling the body, will produce a feeling of warmth. 

THE TURKISH BATH. 

The Turkish bath is a form of physical exercise and is 
of hygienic importance in promoting the circulation, in- 
creasing the nourishment of the various tissues, and getting 
rid of waste matters. It is particularly beneficial to persons 
of sedentary life, who have no other form of exercise, to the 
obese, and to those of a gouty and rheumatic tendency. 

Method of Giving the Turkish Bath. — After undress- 
ing, the person about to take a Turkish bath drinks a glass 
of hot or cold water and lies down upon a couch in a room of 
a temperature of no° to 130 Fahrenheit. If she does not 
perspire promptly she is rubbed or given a hot full bath, a hot 
spray bath or a hot foot bath. After perspiration has begun 
the subject enters a room heated to a temperature of 150 to 
200° Fahrenheit, remaining there but a few minutes until 



40 BATHING AS A MEANS TO HEALTH 

she perspires very vigorously. She is then conducted to the 
shampooing room and placed upon a marble slab. Here 
she is first rubbed from head to foot with the bare hands or 
with Turkish mitts until all the loosened scales have been 
removed and then is shampooed with soap, the lather be- 
ing rubbed in with a clean brush or with a mass of flax, 
manilla, horsehair, or other fibrous material. When the 
whole surface feels like polished marble the subject is given 
a cold douche at 6o° Fahrenheit or less, after which, with a 
sheet wrapped around her, she lies down on a couch until 
dry. The effect is similar to that of other hot baths. 

SEA BATHING. 

An excellent exercise, as well as one of the most in- 
vigorating forms of the cold bath, is surf bathing. The im- 
pact of the waves and breakers upon the skin and the stimu- 
lation due to the salt in the water help to promote a reaction. 
Chilling is to be especially avoided, as it is a sign that the 
person is not reacting well; consequently as soon as a person 
feels cold or her teeth chatter or her lips look blue she should 
immediately come out of the water. As surf bathing is an 
exercise it should not be indulged in when one is overheated 
or exhausted. 

The best time for the ocean bath is in the morning but 
the bath must not be taken until at least two hours after a 
meal. During her menstrual period and in the last months 
of pregnancy a woman must not indulge in sea bathing. 

THE CURATIVE BATHS. HYDROTHERAPY. 

Various forms of baths are employed as a means of 
treating diseased conditions. A cold tub bath is used in 
treating typhoid fever and fevers generally. The various 
sweat baths are used in many conditions, especially kidney 



BATHING AS A MEANS TO HEALTH 41 

trouble and rheumatism. A description of these baths is not 
required in a work of this character. 

THE CARE OF THE COMPLEXION. 

The face should be washed carefully every morning and 
night and at least once or twice during the day. Too much 
washing, however, is harmful. The toilet of the face should 
begin with the thorough cleansing of the hands, as pimples 
and other diseases of the face may be caused by rubbing into 
the skin the minute microbes which are ever present in the 
hands. The face is then washed with clean water. It is best 
to use only cold water as it stimulates the blood vessels and 
improves the circulation in the skin in the manner described 
when speaking of the cold bath. Moreover, the use of warm 
or hot water is likely to produce chapping and roughening 
of the face, especially in winter when it is exposed to cold. 
If, however, after the face has been bathed with hot water, 
cold water be rubbed on it, the blood vessels will recover 
their tone and the injurious effects mentioned will be avoided. 
The best time for using hot water on the face is at night be- 
fore retiring. If the water from the tap is hard, it may be 
rendered soft and more cleansing by the addition of a few 
drops of ammonia or a pinch of borax. The water should be 
applied with the hands, or with a wash cloth. The greatest 
care must be exercised in keeping the latter thoroughly 
clean. A sponge is usually objectionable, as it cannot, as a 
rule, be kept perfectly clean. A complexion brush may be 
used for the nightly scrub. 

The use of soap on the face as a rule is unnecessary for a 
perfectly healthy skin. It may be permissible, however, but 
only in moderation, for persons with oily skins or those ex- 
posed to an atmosphere laden with dirt. The best time for 
the use of soap is at night before going to bed. Oftener than 
twice a day, night and morning, is positively harmful. After 



42 BATHING AS A MEANS TO HEALTH 

being washed the face should be carefully dried with a soft 
towel. 

Care of the Ears.— The ears should only be cleansed 
with a damp cloth and should never be washed with soap 
and water. Nothing should ever be put in the ear, and no 
one but a skillful physician should attempt to remove the 
wax. 

Facial Massage. — It is a good plan in the morning, or 
better twice a day, to thoroughly knead and pinch the face 
with the finger tips. There is nothing better to stimulate 
the circulation of the skin and to improve the complexion. 
This is especially valuable when the complexion is sallow, 
and when there is a tendency to pimples and blotches. 
Rubbing the face with a silk handkerchief after the toilet 
has been completed gives it a pleasing polish which is not a 
shine. It sometimes is of advantage to rub a little alcohol 
or bathing whiskey on the face after the bath. 

The Use of Cold Cream. — One way to cleanse the face 
during the day, is to simply wipe it first with warm water 
and then with cold water, and after this carefully dry it. In- 
stead of this method, however, the face may be cleansed 
with cold cream in the following manner: A good cream 
made of wax and oil of almonds and containing neither vas- 
eline nor animal fat, should be applied to the face and then 
wiped off gently with a soft cloth. Directly after the nightly 
scrub a simple application of cold cream may be made, the 
cream being thoroughly worked in the skin for about ten 
minutes with the tips of the fingers or the palm of the hand 
and then gently wiped off with a soft towel. This anoint- 
ing of the face at night with cold cream or with a little lano- 
lin or almond oil is particularly serviceable when the skin is 
unnaturally dry. 

Face Powders.-— If the skin is very greasy or if the 
weather is hot a small quantity of powder made of rice, tal- 



BATHING AS A MEANS TO HEALTH 43 

cum, starch, bismuth, zinc oxide or magnesia may be applied 
to the face. 

General Hygienic Measures. — Good health being nec- 
essary for a clear complexion, attention to diet, exercise, etc. y 
are important aids in preserving a beautiful skin. 

HOW TO PREVENT WRINKLES AND HOW TO REMOVE THEM. 

There are two ways of preventing wrinkles. One is to 
cultivate a kindly and cheerful disposition, wrinkles fre- 
quently being caused by t^he setting of the muscles of the 
face in certain lines that occur when the temper is bad and 
the disposition sullen or melancholic. Occasionally, how- 
ever, what appears to be a deep wrinkle may be merely a 
condition due to a clogged state of the pores. 

The other method of preventing wrinkles is the care of 
the face in the manner just described, massage being es- 
pecially important. In massaging to prevent or efface 
wrinkles, the tips of the fingers should be moved lightly up 
and outward with a rotary motion. Crow's-feet, or the fine 
wrinkles which appear around the eyes, are sometimes re- 
moved by pinching with the fingers of both hands. Fre- 
quently puckering the lips, as if about to whistle, may ban- 
ish the small wrinkles around the corners of the mouth. 

Chapped Hands. — The most frequent cause of chapped 
hands is the practice in the winter time of bathing the 
hands in warm water without subsequently rinsing them in 
cold water. Women who wash and scrub are especially 
liable to have the skin of their hands become rough and 
cracked, even when the outside air is only moderately cold. 
For many years the author has been treating and preventing 
chapped hands by means of a preparation, consisting of 
equal parts of alcohol, glycerin and rose water. This is to be 
rubbed freely and thoroughly on the hands at bed time and 
at other convenient occasions. 



.CHAPTER III. 

THE CARE OF THE TEETH, THE NAILS 
AND THE HAIR. 

Perfect Teeth are necessary from the standpoint of health as well as beauty. 
How to preserve the teeth: Powder, brush, mouth-wash. Cleansing and 
manicuring the Nails. Structure of the Hair. How to care for the hair: 
Brushing, combing, shampooing, massage. Curling the hair. Hints on 
hair dressing. 

"My Love doth in herself contain 

All this World's Riches that mav far be found; 




If Pearls, her Teeth be Pearls, both pure and round; 
If Ivory, her Forehead Ivory ween; 

If Gold, her Locks are finest Gold on Ground ; 
If Silver, her Fair Hands are Silver Sheen." 

— Spenser. 

EAUTY is in no part of the body so much the result 
of care and attention as in the teeth, the nails and 
the hair: Decayed teeth spoil an otherwise beau- 
tiful face and only too frequently are the result of 
neglect; shapely hands may look unsightly because the nails 
are not well kept; and in many instances beautiful hair 
results from constant care. 

THE CARE OF THE TEETH. 

Perfect teeth not only add to the personal appearance 
but they are necessary to the general health in that they 
permit of thorough mastication of the food. 

The teeth must not be treated roughly. They must not 
be used, for instance, for cracking nuts. 

Particles of food remaining in the teeth after eating 
should be removed by means of dental floss or of a soft 

44 




GIVING THE BABY ITS DAILY OUTING. 

The mother should exercise the greatest care in giving the baby 
sufficient outdoor life and tinder the most favorable conditions. 
Careful directions are given by the author, telling what every mother 
should know in order to secure the best results. 



THE TEETH, THE NAILS AND HAIR 45 

orange wood or quill toothpick, or by means of a tooth- 
brush and lukewarm water. At least twice during the 
twenty-four hours, best before going to bed and as part of 
the morning toilet, the teeth should be cleansed with a pure 
soap or a powder that will polish slightly without harming 
the enamel. A good tooth powder may be prepared from 
equal parts of powdered borax, precipitated chalk and 
powdered orris root. 

The brush should not be too broad. It may be made of 
wood, badger skin or felt, but is best made of bristles. The 
bristles should be long, moderately stiff and elastic. They 
should be of uneven lengths and should not be placed too 
closely together. A new tooth brush should be soaked in 
cold water for several days before being used. After a 
brush has become soft or ragged from long use it should be 
discarded. 

The teeth should be brushed up and down and across, 
both inside and outside. It is well to rinse the mouth with 
a mild antiseptic solution at bedtime or every night and 
morning or after each meal. An excellent mouthwash con- 
sists of tincture of myrrh, rose water and alcohol in equal 
parts, flavored with a drop of oil of almond, and containing 
formalin in the proportion of i drop to the ounce. Dissolv- 
ing a teaspoonful of spirits of camphor and a teaspoonful of 
tincture of myrrh in the water makes another excellent 
mouthwash. Inasmuch as acids injure the dentine they 
should not form part of the mouthwash. 

At least twice a year the mouth and teeth should be 
examined by a competent dentist so that any commencing 
decay may be detected in time. 

THE CARE OF THE NAILS. 

The nails are kept clean by means of soap, warm water, 
and a nail brush and the frequent use of a wooden, ivory or 



46 THE TEETH, THE NAILS AND HAIB 

metallic nail cleaner. The latter should always be blunt. A 
penknife or other sharp instrument should not be used as 
it scratches the under surface of the nail, thus making a 
place that favors the lodgment of dirt. It is better to use an 
orange stick or a soft wooden toothpick for cleansing the 
nails. An excellent instrument is a finger-nail sheathed in 
a folded handkerchief or towel. Once or twice a week the 
skin overhanging the root of the nail should be pressed back 
to prevent it encroaching too far over the half moon and 
thus becoming torn and ragged. For this also the orange 
stick should be used. 

Manicuring the Nails. — The nails should be manicured 
once a week. For this purpose a nail file, a pair of nail scis- 
sors, an orange stick, a chamois nail polisher and a small box 
of nail powder must be provided. The fingers should first be 
dipped in w T arm, soft, soapy water, to which a few drops of 
cologne or compound tincture of benzoin has been added. 
The nails will be softened in a few moments, and then should 
be filed into a curve so that the whole nail will, as nearly as 
possible, approach the shape of an almond. The skin is now 
gently pressed from the root of the nail with the orange 
stick. The nails are next carefully dried and rubbed thor- 
oughly with plain vaseline, after which they are polished 
with the chamois, care being taken not to heat the nails 
with the friction. The nails are once more rinsed and dried 
and are then rubbed with a little fine powder. 

Instead of being filed the nails may be cut with a pair 
of scissors. Finger nails are always cut in a curved direc- 
tion ; toe nails should always be cut straight across. 

Stains are removed from the nails by a solution of one 
part of acetic acid to sixteen parts of rose water. 

THE HAIR AND HOW TO CARE FOR IT. 

The hairs lie imbedded in the scalp, each root being 



THE TEETH, THE NAILS AND HAIR 



47 



contained in a long shaft into which the mouths of the oil 
glands empty, as shown in the accompanying diagram. 

In order to preserve the hair, the scalp must be kept 
perfectly clean and free from dandruff, a condition which is 
obtained by shampooing, massage and daily brushing. Dan- 
druff consists of the old dead cells of the outer skin or epi- 
dermis which have been thrown off by the scalp in the form 
of dry scales. It is most abundant when the scalp is 
unhealthy. 

Brushing the Hair. — The hair should be brushed for 
several minutes every morning and night. The frequent 

stimulation of the circulation 
of the scalp produced by this 
increases the growth of the 
hair. Brushing also removes 
dandruff and distributes 
throughout the hair the 
natural o i 1 which comes 
from the scalp. There is no 
necessity of brushing the 
hair a certain number of 

l^P' ' - • l\) •'! f t i trLes ^ a s some people seem 

| ' ; ' { ;\^ ;;{ ' | to think. The brushing 

should merely be continued 
until a feeling of warmth, 
without soreness, is present 
in the scalp. 
A stiff brush with little 
tufts of bristles, widely separated, should be used for adults : 
one somewhat softer must be employed for children 
and for those with very sensitive scalps. The brush, how- 
ever, should not be so stiff as to produce any soreness. A 
wire brush should never be used as it breaks the hairs and 
pulls them out. 




The Hairs and the Oil Glands 
(Magnified) 

6. The hair shaft. 

ii. The root of the hair. 

7, 8 and 9. The oil glands. 



48 THE TEETH, THE NAILS AND HAIR 

How to Comb the Hair. — Thorough combing does not 
cause a serious loss of hair as many women fear; it removes 
only the loose hairs that are ready to fall and whose place 
will soon be taken by new and more vigorous ones. The 
hair, nevertheless, must be treated very gently. The comb 
should be grasped between the thumb and first two fingers 
and drawn down the length of the hair. It should never 
pull the hair roughly in raking out the snarls. In some 
cases it is better to separate the snarls with the fingers. 

The comb should be coarse and have smooth teeth, with 
blunt ends, set widely apart and with round edges where 
they are joined to the back. The old fashioned fine-tooth 
combs should be discarded, as they not only pull out the 
strong hairs but their fine points often irritate the scalp. 

Cleansing the Brush and Comb. — Once a week the 
brush and comb should be cleansed by being shaken in hot 
water to which a little ammonia has been added. The brush 
should be held parallel to the surface of the water while be- 
ing shaken. After they are washed it is often well to disin- 
fect the brush and comb by placing them for ten or fifteen 
minutes in a solution containing a drop or two of formalin 
or twenty grains of boric acid to an ounce of water. The 
comb should then be carefully wiped between the teeth. The 
bristles of the brush must be wiped so that they will dry 
soft. Standing the brush on its bristles, while it is drying in 
the sun, will prevent the water soaking into the back and 
ruining it. 

It is well not to use a comb and brush belonging to 
another person. 

Massage of the Scalp. — Daily massage of the scalp will 
improve its circulation and increase the growth of the hair, 
especially when the scalp is pale and thin. The finger tips 
should first be moved vigorously over all parts of the scalp 



CAEB OF THE TEETH, THE NAILS AND HAIE 49 

and later, being placed firmly on the scalp, should move the 
scalp over the underlying skull. 

Shampooing the Head. — Shampooing is necessary to 
cleanse the scalp and keep it free from dandruff. Although 
the loose hairs are removed by shampooing, those that are 
left are stimulated to a better growth. The frequency with 
which shampooing is required depends upon the rapidity 
with which dandruff and dirt collect, and thus varies from 
once a month to once a week or oftener. To shampoo the 
hair, tincture of green soap or any good, pure soap should 
be rubbed thoroughly into the scalp with the finger tips. A 
little warm water is then added and a good lather is made 
which must be rubbed vigorously into the scalp with the 
finger tips or with a stiff nail brush. After this the hair 
should be rinsed with warm water, using several waters un- 
til the last is perfectly clear. The danger of catching cold 
is averted if the scalp be then douched with cold water. The 
hair should be dried thoroughly with soft, warm towels, and, 
if possible, also with the heat of the sun or of a fire. Turkish 
towels should not be used as they are too rough, and tend 
to pull out the hairs. The hair should be shaken from time 
to time while drying. After the scalp is dried it should be 
massaged well with the finger tips until the head feels in 
a glow. The scalp always feels dry immediately after wash- 
ing, but, as a rule, it soon becomes oily again owing to the 
improvement in circulation and the stimulation of the oil 
glands. When, on the other hand, it remains dry, it may 
be rubbed with pure vaseline, olive oil, or almond oil, which, 
however, should not be rubbed through the hair. 

The removal of lice and nits from the hair will be de- 
scribed in detail in Chapter XXXI. 

Curling the Hair. — Curling the hair is not objectionable 
if it is not done with too much vigor. Curl papers are not 
likely to do much harm if they are not put on so tightly as 

4 






60 THE TEETH, THE NAILS AND HAIH 

to pull on the roots of the hair. The incessant use of the 
curling iron, however, has a tendency to make the hair un- 
naturally dry and probably spoils the ends. 

Hints on Hair Dressing.— In dressing the hair care 
must be taken not to make violent traction upon the roots, 
which has a tendency to loosen the hair and cause it to fall. 
The hair should be rolled loosely and not squeezed into a 
tight knot. "Rats" and false hair are said to injure the 
growth of the hair b}^ overheating the scalp. The assertion 
is also made that tangling the hair, by combing it in the 
wrong way in order to make the pompadour stand up, is 
injurious and loosens the hairs, which are more apt to be 
broken off. 

Mrs. Symes says that every woman should discover 
the most becoming v/ay of wearing her hair, and then stick 
to it no matter what fashion may dictate. "Suitable and be- 
coming hairdressing," she writes, "may redeem even a very 
plain face, and it is deplorable to see the hair ill treated by 
neglect or dragged into a style which makes it unbecoming 
to the face it should adorn. 

"A woman may have an ill-shaped mouth or crooked 
nose, or little eyes, and still be pretty, if her hair is becom- 
ingly arranged, but if all her other features are good, and she 
has an extremely high forehead with the hair growing upon 
it in an awkward line, she will never be more than a plain 
looking woman, unless she takes means of compromising 
this enemy to good looks 

"Study yourself and you will be surprised how you can 
improve, not only the beauty of your face, but, when wear- 
ing evening dress, even the appearance of your neck and 
shoulders. 

"By dressing the hair low on the nape of the neck the 
thin woman can take a great deal off its length if she wishes 
to do so." 



CHAPTER IV. 

THE FIGURE— HOW TO DEVELOP A 
GRACEFUL CARRIAGE. 

Standard of Beauty in the Figure. The Prevention of Deformities. How de- 
formities are acquired. School a factor in producing deformities. How 
to detect deformities. Mechanical means to prevent deformities. How to 
improve the figure. The correct standing position. The position to be 
assumed when sitting. The proper method of v/alking. Exercises for 
developing a graceful carriage. How to utilize housework in developing 
the figure. Exercises for developing the figure. 

"The human form divine." — Pope. 



BEAUTIFUL figure is seldom the work of Nature 
unaided. Through want of proper exercise and 
consequent absence of muscular development, a 
perfect frame may not appear to advantage. Mus- 
cular weakness, due to the same cause, combined with 
faulty positions, may even produce noticeable deformities. 
A body perfectly formed loses much of its beauty if not 
associated with elegance of poise and grace of carriage. 

On the other hand, one less endowed by Nature may 
possess a striking figure, owing to her physical develop- 
ment and general bearing, which have both been acquired. 
It is in the power of every woman to attain a graceful car- 
riage and well-developed figure and to avoid deformities. 
Standard of Beauty in the Figure. — To say that there 
is but one standard of beauty in the human form would be 
indeed wrong. The types are various. One, like the Venus 
de Milo, is tall and majestic; another delicate and diminu- 
tive, like the Venus de Medici. 

There are certain measurements, however, which have 

61 



52 THE FIGURE 

been accepted by artists generally as being those of the 
ideal female figure. The height of such a model is five 
feet five inches; the waist twenty-seven inches; the bust, 
under the arms, thirty-four inches, and over the arms forty- 
three inches. The circumference of the upper arm is thir- 
teen inches, of the wrist six inches, of the thigh twenty-five 
inches, of the calf of the leg fourteen and a half inches, and of 
the ankle eight inches. The weight of this ideally propor- 
tioned woman should be one hundred and thirty-eight 
pounds. 

These dimensions are somewhat larger than those of 
the Venus de Medici, which is regarded by many author- 
ities as the type of perfect female beauty. 

The height of this figure is five feet, less than that of 
the average American woman. The head is small and the 
face oval in shape, the breadth being two-thirds of the 
length. The waist measures thirty inches in circumference 
and is four inches in length, being a much larger waist 
than that of the fashionable woman of to-day. 

Deformities May Be Avoided. — Such perfection is ne- 
cessarily a gift of Nature. Many irregularities, however, 
occur in the figure which are due to deformities that might 
have been prevented, and to faulty positions that were as- 
sumed through ignorance. 



THE PREVENTION OF DEFORMITIES. 

It is always much easier, to prevent deformities than 
to remedy them after they have occurred. 

How Deformities are Acquired. — Many deformities oc- 
cur during infancy and are directly due to the ignorance of 
the nurse or the mother. 

Children who are improperly nourished often develop 
a condition known as rickets, in which ail the bones are 




THE PRIDE OF WOMANHOOD. 

Health and bianly require that intelligent attention be given to 
the care of the hair, skin, teetli an J nails. These are won 
pride. Directions are given in this volume. 



THE FIGURE 63 

soft. When a child suffering from this disease starts to 
walk, its legs always become bowed. 

Improper methods of holding the baby may lead to 
serious deformities, especially of the spine. The proper 
way in which an infant should be held when carried about 
and when nursed is described in Chapters XXIV and 
XXIX. The back and neck must always be supported. It 
is not well to hold the baby in the arms too much. The 
Hindoo nurse seldom or never takes the infant on her knee 
or in her arms. She puts it down on the floor or on a mat. 
where it lies quietly until it gets sufficient strength to roll 
about. 

Improper clothing may also produce deformities, cor- 
sets and tight lacing being especially harmful. 

Faulty position, however, is the most common cause. 
The proper position for standing or sitting will be described 
later in this chapter. 

Faulty positions in bed lead to curvature of the spine, 
especially in persons who are weak or debilitated. One 
should not always sleep on the same side, but should change 
about. Soft beds and high pillows are especially liable to 
produce deformities. A hair mattress should be used, with 
a rather low, elastic pillow. 

Spinal curvature is also frequently caused by carrying 
books or other weights always on the same arm. When 
these objects must be carried, they should be supported first 
on one arm, and then on the other. 

School as a Factor in Producing Deformities. — A curved 
spine is usually acquired in school, owing to the fact that 
children of all sizes must sit at a uniform-sized desk. 

The desks and seats in the school-room should be ad- 
justable, so that they can be fitted to any child. The desk 
should be one inch higher than the pupil's elbow and should 
have an inclination of about ten to fifteen decrees, its ed^e 



64 THE FIGURE 

projecting slightly over the edge of the seat. The seat 
should be not less than eighteen inches broad, so as to sup- 
port almost the whole thigh, and of such a height that the 
feet rest firmly on the floor when the knee is bent at a right 
angle. With the child sitting in an erect posture the dis- 
tance from the eye to the desk should be sixteen inches. 

Kow to Detect Deformities. — The deformity should be 
recognized and corrected before it becomes too marked. 
As it usually comes on gradually and insidiously, it at first 
attracts little attention. 

The first thing to be noticed will be a considerable de- 
crease of muscular power and a feeling of general depres- 
sion and fatigue from the slightest exercise. The child is 
listless and inactive and has a tendency to lounge and loll 
about in decided contrast to the usual activity of youth. 
There is a disposition to stoop and to appear awkward, care- 
less and ungraceful. 

If the girl be examined, the muscles of the back will 
be found wasted and the ribs will be plainly seen. The shoul- 
der-blades will be prominent, and one will be a little 
higher than the other. The knobs of the spine will pro- 
ject and, instead of being in a straight line, will form a curve. 
In order to bring this out it will be necessary to mark the 
skin along the knobs of the back with ink or with a thick 
pencil, or to rub it until it shows a blush of red. If a 
plumb-line be then dropped from the top of the head along 
the back while the girl stands as erect as she can, the curva- 
ture will be plainly discerned. The deformity may be so 
marked that it can be easily seen without the use of a 
plumb-line. 

How to Prevent Deformities. — Various appliances have 
been used at different times to prevent deformities. Shoulder 
braces at one time were much used, and stays and corsets 
were also very popular. Even backboards were employed, 



THE FIGURE 65 

and certain ingenious collars to hold up the head were at- 
tached to braces, stays or back-boards. A century ago educa- 
tion chairs, stocks, inclines, horizontal planes, the windlass, 
stretching chairs and braces were the means of making young 
women grow up with straight figures. All such mechanical 
contrivances are very injurious and although they may hold 
the back straight for the time being they really tend to in- 
crease the deformity. The body is held erect by muscles. A 
muscle is developed and strengthened by use and weakened 
by disuse. If an arm be kept in a sling for several weeks its 
muscles will become thin and wasted and in time the arm 
will lose its power. In the same manner braces which keep 
the spine straight take the work from the muscles, which 
thereby become weakened. In consequence the girl is un- 
able to hold herself straight without the continued use of the 
brace. 

The proper method to prevent deformities and to cor- 
rect them is with appropriate exercises to strengthen the 
muscles which support the part, and thus by natural means 
to overcome the deformity. 

HOW TO IMPROVE THE FIGURE. 

There are many ways of developing a good figure and 
a graceful carriage. First and most important, is the as- 
suming of a proper position while sitting, standing or walk- 
ing, while at rest and while at work. There are many exer- 
cises, with and without mechanical contrivances, for im- 
proving the figure and there are many sports and games 
which will aid in its development. 

The Correct Standing Position. — Without a graceful 
carriage a beautiful form may appear to disadvantage. Not 
only is correct poise beautiful, but it is in itself of educa- 
tional and hygienic importance. In a slovenly manner of 



58 THE FIGURE 

standing the muscles of the back and abdomen do not get 
their proper share of work, and the person becomes readily 
fatigued. The most common fault with women is that in 
standing they project the abdomen. In an endeavor to pre- 
vent the shoulders becoming round they throw back the 
upper part of the body, at the same time pressing forward 
the abdominal walls. This position usually tires the back 
muscles and causes many of the aches and pains felt in this 
region. 

To stand straight, a girl should place her feet almost 
parallel, the heels being one to six inches apart, as may be 
easiest, the toes turning outward a little, as is most natural 
and comfortable for the individual. She should let her arms 
hang easily by her sides. When the chest is drawn up to 
a high position, all the other parts of the body naturally 
fall into their proper relations with it. The weight of the 
body should be thrown forward on the ball of the foot 
and toes, rather than on the heel. 

The ease and balance of this position may be tested 
by rising on the toes as far as possible, maintaining the 
position for a moment, and coming down gently until the 
heels touch the floor. When this can be done without los- 
ing the balance, the proper position has been assumed; but 
if the person has to take a step forward or backward to 
recover her equilibrium, the center of gravity is misplaced 
and the position must be resumed until, after a few at- 
tempts, the proper position is found and kept. In this posi- 
tion the shoulders, hips and ankles will be in a straight line. 
The correct carriage may be tested by passing the hand 
over the back; if the ends of the shoulder-blades can be 
felt, the carriage is correct. 

The Position to be Assumed When Sitting. — A girl 
should sit on the whole seat of a chair, not just on the edge. 
When she is seated back in her chair, the seat should be 



THE FIGURE 67 

about three-fourths as deep as her thigh. Her feet should 
rest easily upon the floor, or on a footstool if the chair is 
too high. The erect position is maintained by drawing up 
the crown of the head. 

A girl should never lounge in a chair or allow herself 
to flop. If she is too fatigued to sit straight she should lie 
down until she is rested. She should never sit in a chair 
resting on one foot or lean her head upon her hand or bend 
the head forward or stoop at the shoulders. She should 
always lean forward from the hips and not from the waist. 
Unless proper postures are maintained no amount of exer- 
cise can overcome the deformities that will be produced. 

The Proper Method of Walking. — In walking, the cor- 
rect standing position must first be assumed. A girl should 
hold her chin up, her chest forward and her abdomen in. 
The shoulders will then fall into their proper position and 
not have to be pushed back. In walking up stairs she should 
hold herself erect, keeping the back, neck and head in a 
straight line. She should not bend forward in passing from 
step to step. She should never run up stairs, but should 
place each foot flat on the step, taking deep breaths as she 
slowly ascends. She may walk down stairs very grace- 
fully by not springing upon the steps, but by bending the 
knees and dropping the weight from step to step with as 
little motion as possible. 

EXERCISES FOR DEVELOPING A GRACEFUL CARRIAGE. 

The remarkably erect figures of the Turks, mentioned 
by travelers, have been ascribed to the wearing of a 
heavy turban. About two centuries ago a Frenchman 
named Andry, having noticed the erect attitude of milk- 
maids who carried small pails on their heads, applied the 
same principle to the improvement of the figure. He caused 



58 THE FIGURE 

a weight, such as a powder box, to be balanced on the fore 
part of the head where it would be most apt to fall, thus 
exercising the muscles of the back and neck. He introduced 
this balancing as a game in which children might be inter- 
ested. It was adopted in a convent for girls, a forfeit being 
demanded whenever the object was dropped. 

Probably the best exercise to develop a good carriage 
is to carry around on the head a light object, such as a 
bean bag. This should be balanced first in the correct 
standing position and then as the girl walks about the house 
and up and down stairs. 

HOW TO UTILIZE HOUSEWORK IN DEVELOPING THE FIGURE. 

If housework tends to spoil the figure it is because 
no attention is paid to the positions assumed. Yet by ob- 
servance of hygienic principles housework may be often 
utilized in developing the figure. Many girls spend most 
of their time in working about the house and have little 
opportunity for games and sports or sometimes even for 
ordinary exercise. It is of extreme importance, therefore, 
that they utilize their work as a means of improving their 
figures rather than allow them to become deformed by it. 

When sitting at any kind of work, such as sewing or 
paring apples, a woman should avoid the temptation to 
stoop. It is so easy to curve the back and shoulders and 
on getting up to sometimes forget to straighten out again. 
After several years of such bad habits the shoulders will 
be round, the head will protrude forward, the neck will be 
thin and the chest flat and narrow. When standing to one's 
work, the erect posture must be maintained. Kneading 
bread, with the shoulders thrown back, will develop splen- 
did arm muscles. For this, however, the molding-board 
must be at the proper height. One of the best physical 



THE FIGUKE 59 

exercises and one that gives the shoulders splendid devel- 
opment is the old-fashioned scrubbing on hands and knees. 
One must remember, however, to keep the back straight, 
the chest forward and the abdomen drawn in. It is well 
to develop both sides equally by first using one hand and 
then the other. Likewise when sweeping, the broom 
should be changed from side to side to prevent one-sided 
development. The same principle must be applied when 
ironing. In this case it is most important to have the iron- 
ing-board at a comfortable height. 

One should be properly dressed for housework. The 
best costume consists of a loose flannel blouse and short 
skirt made like a gymnasium suit, with the collar loose and 
low. Corsets and high-heeled slippers are entirely out 
of place. 

EXERCISES FOR DEVELOPING THE FIGURE. 

Every woman should devote at least a few minutes dur- 
ing the day to exercise of some kind. Walking, running, 
climbing, bicycling, horse-back riding, rowing, canoeing, 
swimming and dancing are excellent forms of exercise. 
Playing at lawn tennis, tether tennis, golf, basket ball, 
bowling, fencing and punching the bag also greatly aid 
in developing the figure as well as in preserving the general 
health. These various forms of exercise are described in 
detail in Chapter VII. 

Where a woman is unable to indulge in sports and 
games, as is so frequently the case, she can at least spare 
a few minutes for certain simple exercises which require 
no apparatus. The gain in health and in physical appear- 
ance will more than compensate her for all the time she 
spends. 

Breathing Exercises.— One of the chief benefits of all 
exercises is the development of deep breathing that occurs 



60 THE FXGUBE 

with them. Breathing exercises themselves are very im- 
portant. Proper expansion of the lungs not only develops 
the chest and thus improves one's health, but it helps to 
ward off many diseases. If the lungs are always supplied 
with a full amount of air they are less liable to be attacked 
by consumption. Those who are unable to develop deep 
breathing by means of sports and games can at least prac- 
tice breathing exercises for a few minutes each day. These 
exercises are especially important to those with poor chest 
expansion, and to persons just recovering from pneumonia 
or pleurisy. 

In all breathing exercises the chief thing is to inhale 
deeply and slowly until unable to get any more air in the 
lungs. A woman will receive more benefit if when the chest 
is full she will hold the breath while she counts ten. 

These breathing exercises may be combined with va- 
rious movements. From a position down at the sides the 
arms during the inspiration may be raised slowly, with 
the palms up and the arms back and extended, coming 
together above the head just as the inspiratory act has been 
completed. The breath should be held for ten seconds and 
then let out slowly through the mouth, the arms at the same 
time being brought down in front until they reach their first 
position as the last bit of air is forced out. This should be 
repeated five or ten times. 

The best time for the exercises is in the morning be- 
fore breakfast. They should be taken in a room well ven- 
tilated, but free from draught, in which the windows are 
down from the top and open from the bottom. Loose- 
fitting clothing or the night dress should be worn, the feet 
being bare or stockinged to allow the greatest movement. 
Before beginning the exercise the woman should evacuate 
her bladder, clear her nose of all mucus and drink a glass 
of water that is not too cold. 




THE WOOING— ROMEO AND JULIET. 

From earliest days poets have sung of the happy moment in 
a woman 's life when she hears from her lover avowing his devo- 
tion: "When my lips meet thine thy very soul is wedded into mine." 



THE FIGURE 61 

Toe Rising. — The woman should stand with her hands 
on her hips, her body upright, her chin high and her toes 
turned out. With the heels together she should rise slowly 
on the balls of her feet, keeping the knees straight, and 
should then lower the body steadily until the heels touch 
the ground. She should repeat these exercises from fifteen 
to twenty, or even to fifty times. 

Twisting Exercises. — In the same position as in the 
first exercise, turn the body first to one side and then to 
the other, rubbing the hands across the abdomen at the 
same time, and keeping the head in line with the body. 
This may be repeated from five to ten or fifty times. 

Bending Forward and Backward. — Standing in the 
same position, bend forward as far as possible, leaning the 
face forward and kneading the abdomen with the hands. 
Then bend backward, allowing the chin to rest on the chest. 
This may be repeated five to ten times, or gradually in- 
creased to thirty times. 

Bending to the Side. — Bend the body to the side in a 
straight line, without bending forward or backward, until 
the extended hand touches the knee, the other hand being 
brought into the opposite arm pit. Then bend to the other 
side, reversing the conditions. This may be repeated five 
to ten times. 

Elevating the Shoulders.— This is a quick movement, 
excellent for correcting round shoulders and expanding the 
chest. Elevate the shoulders as high as possible without 
drawing in the head; then lower them as far as possible. 
Then draw the shoulders forward, crossing the arms at the 
wrist; then draw the arms up in a cross position, and as 
soon as they reach the level of the chin separate them and 
carry them forward in a circle on each side of the body. 

Windmill Exercise. — Bend the body at right angles to 
the legs and keep in this position throughout the exercise. 



62 THE FIGURE 

With the right hand touch the floor in line with the right 
foot, bending the right knee. At the same time extend the 
left arm straight above the head. Then straighten the right 
knee and carry the right arm up above the head, at the same 
time bringing the left hand down so as to touch the floor in 
front of the left foot and bending the left knee. The body 
must not be raised during this exercise which may be 
repeated five to ten times. 

The Deep Knee Bend. — With the heels raised, lower 
the body as far as possible by bending the knees, while hold- 
ing the trunk erect. Rise, straightening the knees and bring- 
ing them together, not allowing the heels to touch the 
ground until the legs are straight. This is to be repeated 
ten to twenty-five times. 

Floor Exercises. — The following exercise strengthens 
the abdominal muscles and is of great value in preventing 
constipation and even rupture. Lie at full length upon the 
floor with the hands under the hips. Raise both legs slowly 
without bending the knees until they are at right angles 
with the body. Then slowly return them to the original 
position. Repeat this five to ten times. 

Lying as before, first bring one leg slowly to the posi- 
tion at right angles with the body and then as it is returned 
to the original position bring up the other leg. 

The following exercises may be performed after the 
abdominal muscles have been strengthened by the two given 
above: Lie at full length on the floor, with the hands under 
the hips, as before. Bend the knees and bring them up on 
the abdomen as far as possible. Then return them to the 
starting position. Repeat this movement ten times, and 
then again repeat it, bringing the knees up on the abdomen, 
one at a time, for fifteen or twenty times. 

Lie full length on the floor, with the hands clasped be- 
hind the neck, the elbows on the floor. Bring the elbows 



THE FIGURE 63 

in slowly, bending the body forward until the face touches 
the knees. Return to the original position. This must be 
done without taking the feet from the floor. At first it 
will be necessary to have some weight on the feet, or to 
hook the toes under a bureau or chair. Repeat this exer- 
cise several times. 

Forward Drop. — Kneel on the floor, placing the hands 
fifteen inches apart, and stretch out the body and legs. 
Lower the body as far as possible by bending the elbows, 
keeping the back stiff and the legs extended. Then push 
up the body until the arms are straight. Repeat this four 
or five times at first, increased to ten or twelve times as 
you become more accustomed to it. 

A similar movement, though somewhat less difficult, 
may be performed between two upright bars or in a nar- 
row doorway. Stand about eighteen inches from the bars 
or door jams, resting the open palms against them, and by 
bending the elbows allow the body to drop forward through 
the doorway. Then push the body back to the original 
position by extending the arms. Repeat several times. 



CHAPTER V. 

CLOTHING FROM THE HYGIENIC 
STANDPOINT. 

The Hygiene of Undergarments: The material that preserves heat best; the 
best absorbent o£ moisture; the best material for underwear. Stockings. 
Outer Garments: Materials for various conditions; the influence of color. 
Constriction to be avoided. Shoes. Beauty in Dress. The colors that may 
be worn by the different types. Wraps and Coats. Waterproof Clothing. 
Non-inflammable Clothing. 

"A kind and gentle heart he had, 
To comfort friends and foes; 
The naked every day he clad, 
When he put on his clothes." 

— Goldsmith. 

STUDY of clothing must include a consideration of 
the various objects for which clothing is worn. 
These objects are the protection of the body against 
cold, wet, and injury, the absorption of moisture 
from the skin, and the improvement of the personal appear- 
ance. The proper material and color of a garment depend 
largely upon the particular purpose for which it is worn. 

Thus underwear is made of a different material from 
an outer garment. The color of a dress, too, is chosen, as 
a rule, with reference to the prevailing style or whether it 
is becoming to the wearer. 

There are two conditions to be fulfilled by an under- 
garment; it must keep the body warm and it must absorb 
moisture. 

The Material that Best Preserves the Heat. — A gar- 
ment keeps a person warm by not permitting the heat of the 
body to escape ; consequently it must be what is called a poor 
conductor of heat. The power of preserving the heat of the 

64 




CLOTHING FROM HYGIENIC STANDPOINT 65 

body depends chiefly upon the nature of the material, the 
texture of the 'garment, and the number of garments worn. 
Wool and silk are poor heat-conductors. Cotton and linen 
conduct heat well. As air is a very poor heat-conductor, 
the greater the amount of air in the meshes of a material, 
that is, the looser its texture, the warmer the garment will 
be. For the same reason when several garments are worn 
one over another the layers of air confined between them will 
act as non-conductors of heat and keep the body warm. 

The Best Absorbents of Moisture. — Wool and silk ab- 
sorb moisture very easily ; cotton and silk very poorly. Wool 
and silk absorb the perspiration which then slowly evapor- 
ates without producing any reduction in the temperature of 
the skin; cotton and linen, on the other hand, allow the 
perspiration to pass through them to the external surface, 
where it rapidly evaporates, causing thereby a loss of heat 
and sometimes producing a chill. 

The Best Material for Underwear. — The best material 
for underwear consequently is flannel or wool, as each is 
both a poor conductor of heat and a good absorbent of 
moisture. If of a finely combed texture they will not irri- 
tate the skin. Silk is as good, but more expensive. When 
cotton or linen is woven loosely, with large meshes, it pre- 
serves the body heat owing to the poor conductivity of the 
air contained in the meshes. 

Stockings. — Stockings should be made of wool, or at 
least have woolen feet, in order that they may rapidly ab- 
sorb the moisture from the feet. They should not fit too 
snugly, but should be large enough to allow the feet to ex- 
pand when walking. They are best made in rights and 
lefts with straight inner edges or, better still, with a separate 
compartment for the great toe. Underclothing should al- 
ways be removed on retiring and be allowed to air during 
the night. 

5 



66 



CLOTHING FEOM HYGIENIC STANDPOINT 



Clothing should not be too heavy. Light, moderately 
loose garments are warmer than heavy, close-fitting ones, 
affording more space for the non-conducting layer of air. 

Materials for Various Conditions. — For use in hot 
weather, cotton and linen are the best materials for outer 
garments; for cold weather wool is the best. 

The Influence of Color.— Some colors absorb and re- 
flect the heat of the sun's rays more than others. White ab- 
sorbs the heat less and reflects it most; consequently gar- 
ments of that color are the coolest. Yellow is the next cool- 
est color and then come red, green, blue and black, the last 
absorbing the heat most and hence being the warmest color. 
Starching and ironing close the air spaces in clothing, and 
by thus rendering it more impervious help to render it 
warmer. Starched garments are therefore more com- 
fortable in cold weather and unstarched in hot weather. 

Constriction to be Avoided.— Skirts should not be sup- 
ported from the waist, but should be suspended from the 
shoulders by means of a waist or suspenders as shown in the 





Waist and Suspenders for Supporting the Skirts from the Shoulders. 

accompanying figures. Clothing should not interfere with 
the breathing, or compress any of the abdominal organs. 
The article of a woman's dress that has caused more sick- 



CLOTHING EHOM HYGIENIC STANDPOINT 



6? 



ness and injury than any other is the corset. The ordinary 
corset should never be worn. The hygienic corset, or one 
of the corset waists now on the market, such as the equipoise 
or Ferris waist, is not so harmful. 

Circular elastic garters inter- 
fere with the circulation of the 
blood and frequently produce vari- 
cose veins; consequently they 
should never be worn. The stock- 
ings should be fastened to some 
part of the underclothing. 

Shoes.— The shoe should have 
a flat sole and should be nearly 
straight on the inner edge and 
curving gently on the outer side. 
The heels should be broad and 
low. When the heels are high 
they weaken the arch of the foot 
by causing a wasting of the mus- 
cles and ligaments. The shoe 
should be three-fourths of an inch 
longer than the foot; the latter 
works forward in walking and 
unless it is given sufficient room 
will develop corns and bunions. 
The shoe, however, should not be 
so loose as to allow the heel to 
rub. Shoes made of plain leather 
permit the proper ventilation of 
the feet. Patent leather shoes, 
however, are impermeable to air 
and do not allow sufficient evaporation of the perspiration 
of the feet; consequently they should not be worn con- 
tinuously. It would even be better not to wear them at all. 




The Toilet. 



68 CLOTHING FKOM HYGIENIC STANDPOINT 

As rubber also will not permit air to pass through it, boots 
and overshoes of this material should not be worn longer 
than necessary. 

BEAUTY IN DRESS. 

When dress is regarded from the standpoint of im- 
proving the personal appearance, there are many things be- 
sides material and texture to be taken into consideration, 
the most important of which is color. There are certain 
types of women who appear to better advantage when ar- 
rayed in certain colors. On this account a gown which 
appears beautiful upon one woman may seem the opposite 
when worn by another. Every woman should understand 
her own type or style of beauty, and dress accordingly. 
There are many books which give the different colors that 
can be worn by women when the hair, eyes and complexion 
are of certain shades. These teach one to make a much 
closer differentiation than just according to the color of the 
hair. For instance, a distinction must be made between 
red hair with blue eyes and red hair with brown, gray, or 
green eyes. The following colors are suggested by Miss 
Oakley for the various types : 

The Black-Haired Type. — Black hair is most frequently 
combined with black eyes and sallow complexion. The best 
settings for such a combination are black, relieved with 
transparent white, a dark, warm gray and occasionally a 
flame color or a dull red. 

When the black-haired type has pale skin and blue eyes 
the possible range of color is wide, although yellows and 
greens are absolutely excluded. Blue is the best color, blues 
of the sapphire shades, and blues of the Chinese colors. The 
dark reds, such as cardinal, may be worn, also very pale 
shell-pink, blue-grays and white, both cream and blue-white, 
and black, both solid and transparent. 

The Girl with Red Hair. — The following colors are 



CLOTHING FROM HYGIENIC STANDPOINT 69 

possibilities for the entire class of the red-haired type. 
White of a creamy tone, black, invisible green, rich bottle- 
green, rich blue-green, olive-green, gray-green, stone-gray, 
claret color, maroon, plum color, amethyst, brownish purple, 
pale yellow, gold color, pale amber, and the reds approach- 
ing amber. All the girls of this general type, however, must 
avoid blues of all shades, blue-white, pale green, scarlet, all 
bright reds, bright rose-pink, all violet-pinks, blue-purple, 
and lavender. 

Some distinction must be made in regard to the different 
variations of this type. Thus the woman with blue eyes and 
red hair should wear chiefly the greens, stone-gray and yel- 
low, the creamy white and the black; those with gray and 
green eyes may, in addition, dress in the browns and purples, 
while the brown-eyed variety look best in the dark reds and 
ambers, although they may wear any of the colors belong- 
ing to the general type. 

The Brown-Haired Woman. — The typical example of 
this type, with warm, brown skin and brown eyes, may choose 
any of the following colors: all reds, amber, all yellows, 
cream-white, brown, maroon, olive-green, rose-pink in small 
quantities, all warm blue from dark to light, tan colors, fawn 
colors, tea colors, and flame colors. She must, however, 
avoid all cold and pale blues, light green, all cold greens, pale 
violets, violet-pinks, grays, purple, black, blue-white, and 
even the transparent blue-white and gray of white muslin. 

A girl with the same color eyes and hair, but whose 
skin is of a thick, creamy white, may wear black, cream-white, 
purple, violet, amber, olive-green, light or dark reds, es- 
pecially dark reds, all the rich, dark red purples and maroons, 
some dark blue-green like peacock, russet, and rose-pink. 
The following colors, however, are impossible with this 
tpye: blue-white, all light and cold blues, grays, mauve-pinks, 
cold yellows, and pale greens. 



70 CLOTHING FBOM HYGIENIC STANDPOINT 

The chestnut-haired woman with fair skin and Hue eyes 
may employ almost any color except the mauves and mys- 
terious pale colors, but the chestnut-haired woman with 
gray eyes or green eyes, especially if her complexion be dull 
or sallow, must choose more carefully. She may wear olive- 
green, relieved with pale pink, white with contrasts of old 
gold and yellows, dark and light blues, purple relieved with 
white, lilac combined with burnt cream, and black with con- 
trasts of green, especially- the yellow greens. 

The Blonde Type. — -In quite contrast to the warmer 
types is the cool blonde, with her thin, white transparent skin, 
her pale golden or flaxen hair and blue or violet eyes. This 
girl may wear jet-black, blue-black, cold, pale green, blue- 
white, cold grays, all cold blues, heliotrope-purples, cold, 
pale, violet-pink, cold lilacs, and lavender, but must avoid all 
reds, warm blues, yellow greens, olives, browns, yellows, 
warm violets, ambers, cream-white, fawns, tans, and russets. 

Somewhat different from the type just mentioned is the 
golden blonde, of which there are two varieties. The golden 
blonde with the warm, roseate skin usually has hazel eyes, 
and can select her colors from turquoise-blue, rose-pink, 
v/arm greens — from dark to light, cream-white, reds, yel- 
lows, ambers, purple, violet, black, warm grays, fawns, 
brown, and flame color. Although she can wear practically 
everything, she does not look so well in cold blues, mauve 
pinks, cold greens — light or dark, blue-white, lavender, cold 
lilacs, and cold grays. 

, For the golden blonde with gray, green, or light hazeli 
eyes and a luminous creamy white skin quite a different 
choice of colors must be given. This type can wear olive- 
green— light and dark, black, cream-white, all soft yellow 
greens, stone-grays, blue-grays, gray-blue, turquoise-blue, 
pale peacock-blues, transparent white, mauve-pinks, ame- 
thyst — light and dark, heliotrope in all shades, and pale 



CLOTHING FEOM HYGIENIC STANDPOINT 71 

amber. She must avoid orange, brilliant yellow, scarlet, tan 
color, heavy blue-green, blue-white, blue-purple, cold blues, 
lavender, fawns, frank pinks, and all reds from dark to light. 

When the Hair Turns Gray. — There is a type with 
greenish gray hair seen sometimes with brown skin and 
brown or dark gray eyes. Any of the following colors go 
well with such a combination: dark greens, both olive and 
blue greens, browns, including a light brown approaching 
fawn, amber, all rich yellows, yellow-pink, dark reds, the 
warm, rich dark blues, purple, brownish purple, and cream 
white. The following colors, however, cannot be worn: all 
cold and pale greens, all cold light blues, grays, mauve-pink, 
cold lilacs, blue-white, cold yellows, like sulphur color, and 
black. 

When the gray hair is accompanied with a lighter, clear 
complexion, and with color in the cheeks, the browns must be 
entirely omitted, although black and gray may be used. 
The best color for a pale complexion and snow-white hair, 
with gray or blue eyes, is entire black. For a prematurely 
gray-haired woman with blue eyes and a fine, clear com- 
plexion either pale or ruddy, the best combinations are blue 
and white, and pale rose-pink and black, although purple and 
even green may be worn.^ 

WRAPS, COATS AND THE LIKE. 

As wool is impermeable to wind and is of a very low 
heat conductivity, it makes an excellent protection against 
the cold; consequently it is the best material for wraps, coats, 
and shawls. One should not wear mufflers and fur boas 
around the neck as they render the skin sensitive and in- 
crease the liability to catch cold. 

Before or immediately on entering a warm apartment 
all coats and wraps should be removed. In cold weather it 
is sometimes well, on coming in from the street, to wait a few 
minutes in the vestibule before entering the warm house, so 



72 CLOTHING FROM HYGIENIC STANDPOINT 

as to make the change from one extreme to the other more 
gradual. In this way there will be less likelihood of catch- 
ing cold. 

WATERPROOF CLOTHING. 

Rubber, being impervious to air as well as to water, 
should consequently be worn as little as possible. Rain- 
coats made of cravanette or of wool that has been rendered 
waterproof by certain processes, are therefore much prefer- 
able to India rubber garments and mackintoshes. Rubber 
overshoes are often necessary to protect the shoes, but they 
should never be worn unnecessarily and should be removed 
as soon as the person enters the house. The same may be 
said of mackintoshes and gossamers. 

NON-INFLAMMABLE CLOTHING. 

It is said that cotton and linen clothing may be rendered 
fireproof by being immersed in a starch solution containing 
a heaping teaspoonful of powdered borax to each half pint of 
the solution. The fabric is said not to be injured thereby, nor 
is any disagreeable odor imparted to it. It may be washed 
and ironed just as readily after the immersion as before. The 
recommendation has been made that the clothing of those 
who are exposed to the risk of fire in their daily occupation 
be treated in the above manner. 




A REAL MADONNA 

Is one who is able to transmit to her children health cjuI i 
in their infancy. Beauty will also be found with health. Such a 
mother observes carefully the laws for perfect motherhood. 



CHAPTER VI. 
FOOD AND DRINK. 



The hours for meals. Taking sufficient time to eat. Rest after meals. The 
different kinds of food and how to prepare them. Animal foods. Milk 
and milk products. Eggs raw and cooked in various ways. Meats and 
how to prepare them. Fish and shell-fish. The relative digestibility of 
different animal foods. Vegetable foods: Sugars, cereals, roots and tubers, 
green vegetables, fruits. The different beverages: Drinking-water, coffee, 
tea, cocoa, chocolate, alcoholic drinks. 



"In general, mankind, since the improvement of cookery, eat about 
twice as much as nature requires." — Franklin. 



HE object of food is to supply new matter to the tis- 
sues, which are constantly undergoing waste and to 
furnish the body with the materials for the manu- 
facture of muscular force and bodily heat. 
The character of the food a person shall eat depends 
a great deal upon the mode of life. One who takes a con- 
siderable amount of bodily exercise requires a different kind 
of diet from one who leads a sedentary life. People usually 
eat more than is required to make up for the waste in the 
tissues. Children need to provide material for growth as 
well as for wear and tear, and consequently must eat much 
more proportionately than adults. But as they get older 
they continue this habit of eating very generously, although 
the excess is no longer needed for growth. In this habit 
lies the cause of much of the indigestion from which so 
many women suffer, and of the obesity that is so common 

73 



74 FOOD AND DRINK 

at middle life. In old age still less food is needed, because 
less force is then being exerted. The great fault with most 
Americans, among the rich as well as among the poor, is 
that they eat too hastily and partake too freely of animal 
food. Meat should not be eaten oftener than twice a day ? 
once a day being quite sufficient. 

The Hours for Meals. — The time of the principal meal 
will depend on the character of a person's work. It is 
customary in America to eat three substantial meals a day. 
People in the rural districts and many classes in the cities, 
including the great bulk of wage earners, eat breakfast 
immediately after rising, the heaviest meal or dinner at 
noon, and a light supper about six o'clock. Professional 
and business men, however, and all those who lead seden- 
tary lives and are not occupied in physical labor or outdoor 
pursuits, usually eat their heaviest meal or dinner after 
their work is over, between half-past six and half-past 
seven in the evening. This class of men usually breakfast 
at from half-past six to half-past eight in the morning and 
lunch between one and two in the afternoon. There should 
be definite times for meals ; irregularity in eating frequently 
injures the digestive system. 

Taking Sufficient Time to Eat. — Sufficient time should 
always be allowed for meals. The hasty mid-day lunch of 
shop girls and of professional and business men is one of 
the most frequent causes of indigestion. There should be 
an intermission of at least one hour in the middle of the 
day, part of which should be devoted, both before and after 
eating, to rest or pleasant conversation. If one has but 
little time for the mid-day meal it is better to take a very 
light lunch, or even only a plate of soup and a glass of milk 
with a few crackers, than to gulp down a more substantial 
dinner. The habit, however, of going without the mid- 
day meal is most pernicious. 



FOOD AND DUINK 75 

Rest After Meals.— No bodily exercise or severe mental 
effort should be indulged in directly after meals. If the 
blood be taken from the stomach to the muscles or brain 
digestion may be retarded. After a heavy meal rest is 
especially necessary, and may be taken while one is sipping 
coffee or smoking. As sleep, however, retards digestion, a 
person should not retire for two or three hours after a 
heavy meal. 

THE DIFFERENT KINDS OF FOOD AND HOW TO PREPARE THEM. 

Foods may be divided into animal foods and vegetable 
foods. The necessary constituents for a perfect food are 
provided in the most digestible form by a mixed diet, which 
contains both vegetable and animal food, the best ratio 
being one part of raw animal food to three parts of raw 
vegetable food. A person doing hard muscular work, how- 
ever, requires a larger amount of vegetable food than one 
who leads a sedentary life. 

ANIMAL FOODS. 

The animal foods include milk and its products, eggs, 
meats and fish. 

Milk and Milk Products.-— Milk is the cheapest, most 
easily digested and most perfect food we have. It is uni- 
versally used as an article of diet by both civilized and 
uncivilized peoples. As a rule milk is easily digested. Al- 
though spoken of as a liquid food, it is converted, as soon 
as it reaches the stomach, into a finelv divided solid through 
its being curdled by the stomach juices. 

One should drink milk slowly, sipping or chewing it, 
that is to say, mixing it thoroughly with saliva, in which 
case the curds that are formed are of small size. When 
a glass of milk is drunk down all at once it becomes con- 
verted into large, indigestible, cheese-like masses. If milk 
disagrees, it may be rendered more digestible by the addi- 



76 FOOD AND DRINK 

tion of lime water in the proportion of two or three tea- 
spoonfuls to the glass, of aerated water such as vichy or 
seltzer, or of ordinary water. A tolerance for it may be 
established by giving it at first in small doses of one or 
two tablespoonfuls every quarter or half hour and then 
gradually in larger quantities and at longer intervals. 

Cream is one of the most digestible of the fatty foods. 
In the form of ice-cream it is wholesome and agreeable 
when made simply, but when it contains rich flavoring 
extracts or much fruit it is less easily digested. 

When cream or butter are used in cooking they are 
best added after the food has been removed from the fire. 

Butter, as a rule, is easily digested when raw, but is 
less so when cooked. The fatty product margarin, prepared 
from ox fat, is quite as digestible and wholesome as butter 
and, when mixed with butter, forms what is known as but- 
terin, which is much cheaper than butter and is not at all 
harmful when properly made. 

Cheese is not easily digested except when grated very 
fine and mixed with other food. 

Eggs Raw and Cooked in Various Ways. — Eggs are 
most digestible when soft boiled and least so when fried. 
A hard-boiled tgg is not digested rapidly unless it is cooked 
until the yolk becomes mealy, and is thoroughly masticated. 
Next to boiled eggs in point of digestibility come raw eggs. 
Eggs must be cooked at a low temperature or they are 
rendered tough. 

Meats and How to Prepare Them. — Meat is not only 
one of the most important of all the foods, but it forms the 
bulk of the diet of the average American. Raw meat is 
readily digested when thoroughly masticated, but not being 
so palatable as cooked meat, is rarely eaten by civilized 
people. Cooking renders meat more attractive in color, 
more agreeable in taste and more digestible. 



FOOD AND DRINK 77 

How to Stew Meat. — Meat is most digestible when 
properly stewed. The proper way to stew meat is to cut 
it up into small pieces and place it in cold water, which 
is then subjected to moderate heat for some time. By this 
process the juices and flavor will be dissolved out and be 
present in the fluid in which the meat has been cooked. 
This fluid is then eaten with the meat, thus making a savory 
and easily digested dish. 

Boiling Meat. — When a large mass of meat is to be 
cooked in water, or boiled, the flavor and juices must be 
retained in the meat. This is accomplished by first rapidly 
coagulating the surface of the meat by exposing it to a 
high temperature, and then allowing the interior to cook 
slowly at a much lower temperature; consequently the 
water should be boiling when the meat is put into it, after 
which it is allowed to cool, and when it falls to a tempera- 
ture of about 180 F. the whole mass should be boiled until 
it is thoroughly cooked. 

Roasting or Broiling, — The most savory way of cook- 
ing meat is by roasting or broiling. Broiling or grilling 
over an open fire can be done only when the portion of 
meat is small in size; larger pieces of meat may be roasted, 
both in the old way of turning the meat on a spit before 
the grate, or in the modern fashion of placing it in an oven. 
The exposure to the very hot air seals the juices which 
help to cook the inner part. When roasted in the oven the 
meat should be placed for a short time in a very hot oven 
until the hot air rapidly coagulates the outside of the meat 
and thereby prevents the escape of the juices. The meat 
should then be kept for a considerable time at a lower tem- 
perature, usually by placing it in a cooler part of the oven. 
The largest part of the juices will be retained if the meat 
be frequently basted by pouring over it the fat that accumu- 
lates in the dish, thus sealing it more thoroughly. 



78 FOOD AND DRINK 

Fried Meat is Indigestible.— -Fried meat is the least 
digestible of all, especially when cooked in the improper 
manner ordinarily practiced. According to this incorrect 
method some of the fat penetrates the meat, thus rendering 
it tough and indigestible, while at the same time the hot 
partly decomposed fat irritates the stomach. The follow- 
ing correct method of frying does not render the meat 
nearly so indigestible: A deep dish is filled with oil or 
melted fat, which must be boiling at a temperature of from 
350° to 380 F., and the meat is immersed in it. The sur- 
face of the meat is at once completely seared and made 
impermeable. As soon as the meat is cooked, which occurs 
with great rapidity, it is removed from the oil or melted 
fat and permitted to drip. 

Broths and Beef Juice. — The method of making broths 
and beef juice is given in Chapter XXV. 

FISH AND SHELL-FISH. 

Fish is a highly nutritious food, and for the most part 
is easy of digestion, the fatty kinds, however, such as sal- 
mon, whose flesh is of coarse fiber, being less digestible 
than those which are not so rich in fat. 

Oysters are nutritious and wholesome, but the nourish- 
ment is presented in a very diluted form. They are more 
digestible when eaten raw than when cooked. They must 
always be cooked at a low temperature, so as not to be 
rendered too tough. Lobster and crab meat, being coarse 
and tough, are consequently rather indigestible. 

THE RELATIVE INDIGESTIBILITY OF THE DIFFERENT ANIMAL 

FOODS. 

The following list, compiled from the figures of Pen- 

zoldt, Jessen, Richert and Beaumont, gives an idea of the 

relative digestibility of the different kinds of animal food; 

those most digestible are mentioned first: 



FOOD AND DBINK 79 

Milk, bouillon, pigs' feet, trout, boiled calf's brains, raw 
eggs, hard-boiled eggs or omelet, raw beef sausage, boiled 
brains, sweetbread, raw oysters, boiled carp, boiled pike, 
boiled sharper, raw beef chopped fine, half-cooked beef, well- 
cooked beef, raw mutton, cooked veal, boiled codfish, cooked 
pork, roasted mutton, beefsteak, cooked ham, boiled lean 
beef, boiled fish, young boiled chickens, roasted partridge, 
boiled pigeon, roasted bacon, boiled calf's foot, raw ham, 
boiled salmon, pickled and smoked herring, roasted pigeon, 
roasted fillet of beef, beef tongue, smoked bacon, roasted 
hare, roasted partridge, roasted goose, roasted duck. 

VEGETABLE FOODS. 

The various vegetable foods may be divided into sugars, 
cereals, roots and tubers, peas and beans, green vegetables, 
fruits and nuts. 

Sugars. — The sugars of commerce are usually forms of 
cane-sugar, which is chiefly derived from the sugar-cane 
and the sugar-beet. Molasses and syrup are crude forms 
of cane-sugar; maple-sugar contains certain other sub- 
stances in addition to it. 

The chief value of sugar lies in the fact that it gives 
strength to muscles and helps to produce fat 

Sugar should be taken well diluted, as it is best borne 
by the stomach and intestines when eaten in this way. Milk 
and the majority of the fruits, for instance, which are easily 
digested, rarely contain more than 4 per cent, to 6 per cent, 
of sugar. The reason that candies, jams, preserves and 
syrups are often indigestible is that the sugar they contain 
is in too concentrated a form and causes an acid to form 
in the stomach. 

When eaten at all, candy is best taken after a meal. 
Taken between meals, it disturbs the digestion and spoils 
the appetite. 

Cereals. — By cereals are meant the grains that are used 



80 FOOD AND DRINK 

for food. They are rarely eaten until they have been gran- 
ulated or ground into powder, forming flour. Cereals must 
be cooked before they can be utilized as food. All starchy 
foods require long cooking. The coarser meals may be 
boiled and eaten with sugar and milk or cream. 

Flour is usually made up into bread, which is one of 
the most nutritious forms of food. It is an important sup- 
plement to meat and fish, but is not a perfect food in itself. 
Too hot or too fresh bread is very indigestible, as it is con- 
verted, by chewing, into a tough, dough-like mass. Stale 
bread is much more digestible, as it crumbles into finer 
particles. Toasting bread thoroughly until it is brown and 
crisp renders it more digestible, but to toast only the sur- 
face and leave the interior soft does not increase its digest- 
ibility to any degree. 

Roots and Tubers. — The most valuable of the vege- 
tables that grow beneath the ground is the potato, new or 
young potatoes being more nutritious than old ones. Pota- 
toes should be baked or roasted in their skins to retain all 
their nourishing qualities, a great part of which is lost 
when they are boiled or stewed. They must be cooked for 
a long time in order to convert the raw starch into a digest- 
ible form. Potatoes are most digestible and mealy when 
baked; they are least so when stewed, boiled, fried or cooked 
in chunks to be swallowed in considerable masses. Carrots, 
parsnips and beets are not easy to digest. Turnips have 
little nutritive value. Tapioca and sago are nutritious, 
though the first takes too long a time to digest. 

Peas and Beans. — These contain more protein than 
any other vegetable. This is the element that makes meat 
so nourishing. Peas and beans thus form good substitutes 
for meat when for any reason the latter cannot be taken. 
They are not quickly digested, however, being least digest- 
ible when simply boiled and most digestible when mashed. 



FOOD AND DRINK 81 

The Green Vegetables. — The green vegetables are eaten 
chiefly because of their agreeable flavor, and because they 
add variety to the diet. They have little nutritive quality. 
They are very laxative, however, and counteract any ten- 
dency to constipation. 

Fruits. — The various fruits are usually eaten as a relish, 
as their value as a food is comparatively small. The banana 
is the most nutritious of the raw fruits. Cooking usually 
renders fruit more digestible, but cooking in water causes 
it to lose part of its nutritive ingredients. 

THE DIFFERENT BEVERAGES. 

Drinking Water. — The average person requires from 
four to eight glasses of water daily. Drinking water may 
be cooled, but it ordinarily should not be extremely cold, 
especially when one is overheated. The excessive use of 
cold drinks is responsible for many of the cases of intestinal 
disorders that occur in the summer. At meal times water 
should be taken very sparingly and only when the mouth 
is empty, as the tendency to wash half-masticated food into 
the stomach is very injurious. Large quantities of water 
taken with the food dilute the juices of the stomach too 
much and thus interfere with the digestion of the food. A 
small quantity of cold water, however, taken just before a 
meal has a tendency to increase the appetite. Sore throat 
is often caused by the drinking of ice water after having 
swallowed something hot. 

Coffee. — Coffee affects different people variously. Some 
are made very nervous and sleepless by it. As a rule it 
cannot be taken by dyspeptics, especially if cream and sugar 
are added to it. It should not be drunk when the mouth 
is full, and thus wash down food which has not been thor- 
oughly masticated. Coffee should never be given to chil- 
dren. 

Tea, when taken in small quantities, may do no harm, 
6 



82 FOOD AND BRINK 

but when drunk to excess may have very injurious effects. 
It then not only produces wakefulness, nervousness, excita- 
bility and even muscular trouble, but it frequently gives 
rise to digestive disorders as shown by flatulence, a feeling 
of disturbance in the region of the stomach, and constipa- 
tion. It often may give rise to irregularity of the heart, 
pain in the chest and sleeplessness. Children should never 
be given tea to drink. 

Cocoa and Chocolate differ from tea and coffee in being 
nutritious as well as stimulating. They never produce 
nervous symptoms even when taken to excess. They may 
be given to children. 



CHAPTER VII. 

WORK, REST AND RECREATION. 

Work in its relation to health. Child-labor. The length of the working day. 
The necessity for Rest. The noon hour. The ability to relax. The weekly 
and yearly vacation. The hygiene of sleep. Amount of sleep required. 
The bed and the bed clothes. The way to lie. Fresh air in the bedroom. 
Rules for sleeping and preventing insomnia. The necessity for Recreation. 
Mental recreation. Physical recreation: Walking, running, climbing, bicy- 
cling, horseback riding, rowing, canoeing, swimming, lawn tennis, tetter 
tennis, golf, basket ball, bowling, fencing, punching the bag, dancing. 

"Alternate rest and labor long endure." 

— Ovid. 

WORK IN ITS RELATION TO HEALTH. 



HE health may be affected by the character of one's occu- 
pation. Having to work in overcrowded, badly venti- 
lated rooms renders a person liable to disease. Various 
deformities may be produced when the work demands 
constrained attitudes of the body or unequal exertion of both 
sides. Frequently a sedentary occupation, through the conse- 
quent lack of exercise and fresh air, bears a causal relation to 
ill health. Nevertheless, the detrimental influence of any occu- 
pation upon health and length of life may be considerably re- 
duced by attention to the ventilation of the working-room, by 
eating in a proper manner well-prepared, digestible food, and 
by participation in active outdoor exercise. 

Child-Labor.— One of the chief factors that tend to impair 
the vitality of the race is the tender age at which girls are often 
sent to work and the long hours which they must spend at 
monotonous labor. This produces a physical deterioration in 
the mothers which shows its influence in the offspring. It is 

S3 



84 WOBK, BEST AND EEOEEATION 

wrong for children under fourteen years of age to work in 
mines, factories or workshops. In childhood the various organs 
are constantly undergoing development. For this fresh air, 
healthy outdoor exercise and freedom from care are necessary. 
Stunting the growth of the child and depriving it of the benefits 
of education are two of the surest means of causing the men 
and the women to be undeveloped physically, mentally and 
morally. 

The Length of the Working Day. — The length of the 
working day depends to a great extent upon the occupation, 
but as a rule it should never exceed ten hours for men and 
eight hours for women and youths; the greater the physical 
exertion or the mental strain required in an occupation, or the 
greater the danger to which the worker is subject, the shorter 
must be the working day. Working overtime ought never to 
be allowed. 

THE NECESSITY FOR REST. 

The Ability to Relax. — A woman should be able to relax 
at intervals. When the eyes are steadily engaged in near work 
they should be rested every half hour or every hour during the 
day by being made to look off into the distance for a moment 
or two. It is well to relax the mind in the same way by now 
and then ceasing thoughts of one's work and for a moment 
recalling something pleasant that has been seen, read or noticed. 
One tending to become nervous is advised by Dr. Walker to 
stop and take a few deep breaths as a way of relaxing the ten- 
sion. An English physician who has had wide experience in 
treating nervous patients suggests as a means of meeting a 
shock and breaking its force that a person stop for a minute 
and fix the attention on some trivial object, such as a hen out- 
side in the yard. For instance, before opening a telegram one 
is advised to go to a window and look intently at some object 
outside. 




DRESSING THE HAIR. 

This is too often considered a matter of little importance, yet 
the laws of health and beauty require that early in life the girl be 

taught to care for her beautiful tresses. 



WORK, REST AND RECREATION 85 

The Noon Hour. — In the middle of the day a rest from 
work of af least one hour should be taken so that time will be 
allowed for half an hour's freedom from work after luncheon. 
This time should be spent by those who have been standing all 
morning in reclining, and by those who have been sitting in 
walking in the open air. A person employed in manual labor 
might spend this time in reading, but one who has been using 
the brains should spend it in active exercise. 

The Weekly and the Yearly Vacation. — At the end of 
each week a person should rest for at least twenty-four hours. 
Once a year, too, a complete rest of not less than two weeks 
should be taken; preferably in the summer time. The vacation 
restores the weakened muscles and digestive organs to their 
normal healthy condition after the close strain, of the winter's 
work. 

THE HYGIENE OF SLEEP. 

The value of sleep depends much more upon its soundness 
than upon its duration. When disturbed by dreams it is of 
much less value than when it is dreamless. 

The Amount of Sleep Required. — The average adult re- 
quires eight hours of continuous sleep each day. Children 
require much more sleep, as stated in Chapter XXVIII. Aged 
persons do not need quite so much. Persons who have to rise 
early during the week would do well to lie in bed longer on the 
day of rest. 

The Bed and the Bed Clothes. — One should sleep on a 
fairly hard but comfortable mattress with a springy yet firm 
surface. Feather beds and feather pillows should be disre- 
garded altogether. One good hair pillow is usually sufficient. 
The covers should be light but warm, two light blankets being 
warmer than one that is heavy, on account of the layer of air 
between them. The bed clothing should be thoroughly dried 
and aired every day, being preferably exposed to the sun. 

The Way to Lie. — It is a bad habit to prop the head with 



86 WOBK, BEST AND EBCREATION 

many pillows, which tends to cause a strain on the muscles of 
the neck and produce round shoulders or other deformities, 
besides often being the cause of nightmare and restlessness. 
Not more than one pillow or bolster should be used. Some 
girls make a practice of sleeping without any pillow at all, on 
the theory that lying perfectly flat on the back is not only con- 
ducive to restful sleep, but keeps the shoulders straight. It is 
usually considered best to lie on the right side. One should 
lie stretched out rather than curled up. 

Fresh Air in the Bedroom. — It is necessary to have plenty 
of fresh air in the room during both winter and summer. Cold 
air will not render one liable to taking cold, provided the body 
is well protected with the covers. 

Rules for Sleeping and Preventing Insomnia. — No gar- 
ment should be worn at night that has been worn in the day- 
time. During the night all the day clothing should be well 
aired. When a person is tired and sleepy she should go to bed 
and not lie around dozing all the evening. One should not go 
to bed hungry, but instead may take some light, simple food 
before retiring. 

The taking of a glass of warm milk or a cup of hot bouillon 
before going to bed may draw the blood from the brain to the 
stomach of those who persist in planning and thinking after 
their heads touch the pillow, thus serving to induce sleep. 
When the mind is excited or full of business or other worries, 
it may often be calmed before bed-time and turned into pleasant 
channels by half an hour's reading of a light novel or short 
story. A hot bath taken before retiring, or a hot pack, or the 
application of hot compresses to the spine after getting in bed, 
will often aid in producing sleep in a person subject to insomnia. 

THE NECESSITY FOR RECREATION. 

For the preservation of the health habitual recreation is 
absolutely essential. There are two kinds of recreation — men- 



WORK, REST AND RECREATION 87 

tal and physical. The kind a person needs depends altogether 
upon the vocation; a change is what is required. A person 
whose work is largely physical requires physical rest and mental 
exercise at the end of the day's work. One who continually 
uses the mind needs to relax the mind and exercise the body. 

MENTAL RECREATION. 

An overworked mind finds rest in pleasant conversation, 
in cheerful games which are not too intricate, in seeing plays 
and hearing operas, in reading pleasant books and in the culti- 
vation of fads. A hobby, such as the collection of stamps, rare 
prints, old coins, old china, old furniture, and the like, furnishes 
an agreeable diversion by taking one's mind off the daily wor- 
ries. On the other hand, recreation involving some mental 
labor may be of advantage to a person whose work is physical 
and whose mind is little exercised. For such a one chess-play- 
ing is an interesting diversion and even Sunday-school teaching 
may prove beneficial. These forms of recreation, however, are 
injurious to one whose mind is constantly on a strain, such as 
a public school teacher. 

PHYSICAL RECREATION. 

Every one who is not employed in some laborious occupa- 
tion requires physical recreation. Especially is this true of 
those who lead sedentary lives. For an exercise to be of benefit 
it must give pleasure and be accompanied by freedom from 
cares. A walk taken simply for the pleasure of it is much more 
beneficial as an exercise than a walk to or from one's place of 
business, the first being a diversion, the second often a strain. 

There are various forms of physical exercise, some of 
which can be participated in by all while others require special 
apparatus and grounds. As stated in Chapter IV, the various 
forms of physical exercise, including games and sports, are 
especially useful in developing the figure. 



88 WORK, REST AND RECREATION 

Walking. — The most natural form of exercise and the one 
most generally utilized is walking. This is a very valuable 
exercise when sufficient time is taken for the natural swing of 
the leg to bring the foot forward at the completion of each 
step. The girl should hold her chest high, moving her legs 
freely from the hips with a long swinging step and letting her 
arms hang easily at her sides. Rapid walking utilizes every 
muscle of the body, and by agitating the body at every step 
stimulates the functions of the abdominal organs. 

Running is beneficial, but should not be pursued to the 
point of exhaustion or of respiratory embarrassment. The 
combination of alternate slow running and walking is an even 
better exercise than either alone. 

Climbing or walking up a grade is excellent if done with 
frequent resting. Before attempting mountain climbing it is 
well to practice first on small hills. A light loose dress should 
be worn, consisting of a flannel waist and a short skirt. The 
shoes should be easy fitting with thick soles and broad low heels. 
They may have spikes or nails in the heels if the climbing is to 
be long and hard. When the health is delicate, or the heart or 
lungs weak, climbing should never be undertaken without the 
advice of a physician. 

Bicycling. — If pursued at a moderate gait and for moder- 
ate distances, bicycling is in many respects an ideal exercise, but 
it is harmful when continued to the point of exhaustion. 

Horseback Riding not only develops the legs and thighs, 
but stimulates the abdominal organs through the agitation 
caused by the up and down motion of the horse. When the girl 
rides in a side saddle she should use one with reversible pom- 
mels, sitting one time on the right side and another time on 
the left. Riding astride with a divided skirt develops the body 
more symmetrically and in the opinion of the author is not 
objectionable. 



WORK, REST AND RECREATION 8tf 

Rowing. — Nearly all the muscles of the body are brought 
into play by rowing, especially those of the forearm, shoulders 
and back. The abdominal muscles are used in the forward 
swing, while the back muscles are exerted in the backward 
pull. The bracing of the feet develops the muscles of the legs 
and thighs. The swing should come from the hips. The car- 
riage is much improved by this form of exercise if during it 
the body is held in the proper position. The most important 
point to bear in mind is to keep the back flat and not to bend 
the head. It is well to wear flannels while rowing. 

Canoeing does not exercise so many muscles as does row- 
ing, but develops chiefly the muscles of the upper back, arms 
and wrists. The side movement or twisting of the trunk which 
comes in with a double-bladed paddle is beneficial in stimulating 
the internal organs. A girl should neither row nor paddle 
unless she has learned how to swim. 

Swimming brings nearly all the muscles into play. It 
straightens round shoulders, develops the muscles of both the 
arms and legs, throws the chest forward, and by keeping the 
back on the stretch in the effort to keep the head above water, 
tends to develop a graceful poise. 

Lawn tennis has always been popular. It is one of the 
few sports in which most girls can indulge. A vigorous game, 
necessitating running to all parts of the court, it not only de- 
velops all the muscles of the body, but makes the shoulder joints 
and the waist supple, strengthens the wrist and brings grace 
and agility to the motion of the arms and legs. 

Tether tennis does not require a court or expensive appa- 
ratus ; it can- be played in the smallest yard. A girl should wear 
flannels or a sweater when playing this game, as she is very apt 
to become overheated and may become chilled after perspiring. 
Probably more exercise can be derived in a shorter length of 
time from this game than from any other. 

Golf enjoys great popularity among the wealthier classes, 



SO WORK, REST AND RECREATION 

its greatest benefit coming from the walking and the length of 
time spent out in the open air. 

Basket Ball is an ideal exercise, developing all the muscles 
equally and increasing the power of the heart and lungs. In 
match games, however, the physical benefits do not compensate 
for the nervous strain and exhaustion. 

Bowling is a vigorous game and one very popular during 
the winter months. The twisting of the trunk that it brings 
is beneficial to the abdominal organs. The disadvantages of 
this game, however, are that the ventilation in bowling alleys 
is usually poor, and the exercise is usually of a one-sided char- 
acter. 

Fencing. — For those who have the time to devote to it 
and the money to provide the equipment, there is hardly a better 
all-around exercise than fencing. Girls should learn to fence 
with both hands, so that their arms and legs will be developed 
symmetrically. Practice at fencing will bring a lighter step, 
grace of movement and a more agile form. 

Punching the Bag. — An excellent form of indoor exer- 
cise is the use of the punching bag. If one of the men in the 
house owns such an apparatus the girls should certainly take 
advantage of it. By its use every muscle of the body is brought 
into play. The bag should hang about on a level with the 
shoulders. A light flannel gymnasium suit should be worn 
during this exercise. A pair of light gloves will also be needed. 

Dancing is sometimes the only form of exercise a girl will 
have during the winter. It is a useful form of exercise, and 
probably more than any other tends to develop grace of move- 
ment. 



PART II. 
A WOMAN'S LIFE. 









:' 




THE TRYST BY THE SHADY WALL. 

Young manhood enamored by the loveliness of beautiful 
womanhood feels that "But to see her was to love her.'" 



CHAPTER VIII. 

ANATOMY AND PHYSIOLOGY. 



Sex throughout nature: In plants; in the lower animals; in man. Woman's 
physical characteristics. The female sexual organs : In plants ; in the lower 
animals; in woman. Woman's reproductive organs: The womb, the vagina, 
the Fallopian tubes, the ovaries. The pelvis. 

"Shalt show us how divine a thing 
A woman may be made/' 

— Wordsworth. 



I 



N the first part of this book, on "Health and Beauty, 
general hygienic rules have been given which apply 
to every one, irrespective of sex. The present sec- 
tion deals entirely with the phenomena which are 
peculiar to woman, giving those particular rules which are 
to guide her through a healthy and, consequently, happy 
adolescence, maidenhood, wifehood and motherhood. Be- 
fore any suggestions are made as to the precautions to be 
observed during each period, the physiology of that period 
is described, so that the suggestions may be followed in- 
telligently. In discussing physiology, a broad view of life 
has been taken, showing woman's true position in nature 
and her relation to the others of God's creatures. 

SEX THROUGHOUT NATURE. 

All living matter possesses the power of reproduction. 
This is, in fact, one of the characteristics which distinguish 
it from non-living matter. In all the higher forms of life, 
both animal and vegetable, a special portion of each or- 

93 



94 ANATOMY AND PHYSIOLOGY 

ganism is set apart for this distinct purpose. The elements 
necessary to the formation of a new plant or animal are 
usually not all found in one individual but are divided be- 
tween two, which are known as male and female. These 
must unite to form the new organism. The offspring de- 
velops from one element, the female, as soon as the other 
element is added to it. In flowers this distinction of sex is 
recognized, the stamens representing the male element, the 
pistil the female. Willow trees show this sexual differen- 
tiation, some producing only those catkins or pussy-willows 
which consist entirely of pistils and others blossoming only 
into stamen-bearing catkins. In the familiar corn or maize 
the "tassel" is the male flower, the "silk" is the female. 

FEMALE ORGANS IN PLANTS AND THE LOWER ANIMALS. 

Each sex has its generative organs well developed. In 
the centre of every -flower stands the pistil, the upper por- 
tion forming the style and the stigma, the deep-seated por- 
tion being the ovary, which contains, the ovule. When the 
flower is fertilized by the male element — the pollen — the 
ovary begins to develop and to form seeds, which, when 
planted, put forth leaves and stalks and finally bear flowers, 
just as did their parents. The pod with its peas or beans 
and the apple or pear with its seeds represent the ovary of 
the plant. 

In the animal kingdom sexual organs are possessed by 
even the lowest members. The ovary of the fish, for in- 
stance, is familiar as the roe. It contains countless ova 
which, when deposited, are known as spawn. These ova, 
upon being fertilized, become the eggs, from which later 
the baby fish are hatched out. 

In birds the ovum is fertilized while in the ovary, and 
is then laid in the form of an tgg, to be hatched outside the 
mother's body. Every woman who has dressed a hen has 



ANATOMY AND PHYSIOLOGY 



95 



seen its ovary with the unfertilized ova and the fertilized 
eggs. 





Sexual Organs of Flowers. 



A. Flower, showing the stamens around the ovary. 

B. Ovary before fertilization, showing a few stamens still attached. 

C. Ovary after fertilization. It is developing and forming seeds. 

D. The fully developed ovary (the pod), containing seeds. It has been 
cut across to show the seeds. 

E. A seed. 

In all the lozver animals the embryo, as the unborn off- 
spring is called, develops and obtains its food outside of 
the parent's body. The chick, for example, lies within an 
egg f nourished b} r the white and the yolk, and protected 
by the shell. 

In the higher animals, such as the mammals, the off- 
spring must obtain its nourishment from its mother while it 
is developing as well as after it is born. It also must be pro- 
tected by her body. The organ in which the embryo lies 



98 



ANATOMY AND PHYSIOLOGY 



while being formed into a living child is called the uterus 
or womb. 

WOMAN'S REPRODUCTIVE ORGANS. 

The Uterus (also called womb, matrix, bed, nest and 
mother) is a hollow organ, shaped like an inverted pear. 
It is about two inches and a half long, one inch and a 




Front View of Woman's Reproductive Organs. 



U. The uterus or womb. C. The cervix or neck of the womb. V and 
V. The vagina. (This, normally, is a tube. In the picture a longitudinal cut 
has been made along the top or roof, and the sides are pulled out.) O and O'. 
The ovaries. T and T'. The oviducts or Fallopian tubes. P and P'. The funnel- 
shaped distal ends of the Fallopian tubes. (The right-hand side of the picture 
shows the ligament that holds the womb in place. The left of the picture 
shows the ligament cut away and the tube pulled out of position.) 



ANATOMY AND PHYSIOLOGY 97 

quarter wide and three-quarters of an inch thick. The 
walls are composed of thick muscles, leaving a triangular 
cavity only big enough to hold about half a teaspoonful of 
liquid. It ends below in a neck, called the cervix, traversed 
by a narrow canal, called the cervical canal, an inch and 
a half long. The upper end of this canal, where it opens 
into the cavitv of the uterus, is called the internal os or 
mouth; the lower opening is the external os or mouth. The 
body and the neck of the womb are both lined with a mem- 
brane containing glands, which secrete mucus. When too 
much of this mucus is secreted the condition called leu- 
corrhea, or "the whites," results. 

The neck of the womb projects into a tube, called the 
vagina, about four inches long. The walls of this tube 
normally lie in contact but are capable of being stretched 
to a considerable extent. The vagina also is lined with a 
mucous membrane containing glands that secrete mucus 
which acts as a lubricant. It opens externally, but in a 
maiden is partially covered by a thin membrane called the 
hymen. 

The uterus is supported by means of ligaments fastened 
to each side and attached to the bones. It is slung between 
the two ligaments just as a person is supported in a ham- 
mock. 

Along the upper border of the ligaments lie the ovi- 
ducts or Fallopian tubes, which open into the womb at the 
top on each side. They are narrow tubes, about four inches 
long, running outward from the corners of the womb and 
opening like funnels at their other extremities, where they 
are in contact with the ovaries, connecting them with the 
womb. They also are lined with mucous membrane. 

The ovary is like an almond in shape and size and hangs 
in the fold of the ligament just below the Fallopian tube, at 
its distal end. It is a gland secreting ova or eggs. It prob- 

7 



ys 



ANATOMY AND PHYSIOLOGY 




The Lower Abdomen in a Woman. 

A side-view, with the organs cut in half, showing the shape and position 
of the womb and its relations to the other organs. 



1. Uterus (or womb). 

2. Cavity of womb. 

3. Neck of womb (or cervix). 

4. Cervical canal. 

5. External os (or mouth) of the 

cervix. 

6. Vagina, 



7, 19 and 20. Vulva (or external 

parts). 

8. The bladder. 

11. The rectum, outer wall. 

12. The same, cut open. 

13. The anus. 



ANATOMY AND PHYSIOLOGY 99 

ably also secretes a substance necessary to woman's health, 
about which not much is known. 




The Pelvis. 



The uterus and its appendages, as the tubes and ovaries 
are called, lie in a bony basin, called the pelvis. 



WOMAN'S OTHER PHYSICAL CHARACTERISTICS. 

The average woman weighs about twenty pounds less 
than the average man and is five inches less in height. Her 
shoulders are narrower and more rounded and set further 
back; the collar bone is longer and less curved, giving the 
chest greater prominence; the pelvic bones are larger and 
spread out more, making the hips much broader in outline. 
All the other bones, however, are smaller and more deli- 
cately fashioned. The presence of fat under the skin gives 
a more rounded and smooth appearance generally. 



CHAPTER IX. 

THE PERIOD OF PUBERTY: PASSING 
FROM GIRLHOOD TO WOMANHOOD. 

The changes that occur at adolescence. Variations in the age of puberty due 
to climate, race, mode of life, and heredity. Delay in the appearance of 
the chief sign of puberty. The Mental Changes at Puberty. The Religious 
Changes. The Mother's Duty. The Hygiene of Puberty. 

"Standing with reluctant feet 
Where the brook and river meet, 
Womanhood and childhood fleet!" 

— Longfellow. 



I 



N the child the sexual organs are but partially devel- 
oped and remain inactive. At about the end of the 
fourteenth year, however, they begin to functionate, 
and the girl becomes capable of reproduction. The 
period at which this occurs is called puberty or adolescence. 
In addition to the changes in the generative organs, 
other alterations take place in girls at this period. The 
figure begins to assume the aspect of womanhood, the 
breasts become developed, the pelvis and abdomen enlarge, 
the voice undergoes a change, hair appears in the arm-pits 
and about the pubic region, and the menstrual flow, or 
monthly sickness, is established. 

VARIATIONS IN THE AGE OF PUBERTY. 

Although puberty usually occurs about the thirteenth 
or fourteenth year, it may appear earlier or later, its onset 
being influenced by climate, race, mode of life, and heredity. 
In tropical climates it may occur at nine or ten years of age ; 
in Egypt and Sierra Leone it occurs normally at ten years. 
In these climates it is said not to be an uncommon thing 
for a girl to be a mother at twelve. 

100 




THE GOLDEN WEDDING DAY. 

Let prudence with good nature strive, to keep the flame of love alive, 
Then, come old age when' er it will , your friendship shall contin 



THE PERIOD OF PUBERTY 101 

Puberty occurs late in the cooler climates and among 
the peoples normally inhabiting them. In Lapland, for in- 
stance, menstruation does not appear until the eighteenth 
year. The Teutonic and Anglo-Saxon races while in their 
[European homes arrive at adolescence oftenest in the fif- 
teenth year. In the United States and Canada puberty 
usually occurs about the fourteenth or fifteenth year. 

In Hungary the three races, Slavonic, Magyar and 
Jewish, living side by side in the same climate, reach 
adolescence, respectively, when sixteen, fifteen and thirteen 
years of age. Hindu girls of Calcutta and negresses of 
Jamaica, also living in the same climate, begin menstruat- 
ing at the eleventh and fifteenth year, respectively. Some 
writers state that blonds mature earlier than brunettes. 
Menstruation in Jews begins a year or two in advance of 
other races in this country. In negroes and Creoles the 
monthly sickness appears earlier than in white people. 

The influences of city life, with its excitement of par- 
ties, theatres and the like, association with the other sex, 
and sexual temptations, tend to hasten the oncoming of 
puberty. 

It is said that diet has an influence, that stimulat- 
ing foods, such as pepper, vinegar, mustard, spices and con- 
diments generally, tea and coffee, and an excess of animal 
food have a clearly appreciable influence in prematurely 
bringing about this condition. 

Heredity may affect the time of puberty, it being a 
matter of common observation that in some families men- 
struation may begin early through several generations. 

DELAY IN THE APPEARANCE OF THE CHIEF SIGN OF PUBERTY. 

Although other signs of puberty may occur at the usual 
time, the menstrual flow may be late in making its appear- 
ance. 



102 THE PERIOD OF PUBERTY 

This is usually due to a condition of anemia or im- 
poverished blood, caused by want of sufficient sunlight, fresh 
air, exercise, good food and sleep, and by a too close appli- 
cation to study. 

The mother is often alarmed when the menstruation 
is delayed, and may try various home remedies to bring it 
on. The non-appearance of this phenomenon need not be a 
matter of concern, provided the general health is otherwise 
good. No medicine should be given for the purpose of 
bringing on the monthly sickness. Let the girl have plenty 
of good, nourishing food, sunlight, fresh air and out-door 
exercise. In time everything will be all right. 

If, however, the girl seems in poor health, or if she 
suffers much from pain, headache, nervousness and general 
discomfort, she should be taken to the family physician. 
Under treatment directed to her general condition, she will 
probably become a healthy, normal girl. The services of a 
gynecologist or specialist in women's diseases are almost 
never required. The fault seldom lies with the generative or- 
gans; it is unwise, moreover, to call attention to them. A 
modest young girl should never be subjected to an examina- 
tion, even by a female physician, unless there is ground for 
suspecting something serious to be the matter. The mere 
fact of menstruation being delayed is not sufficient cause. 

THE MENTAL AND RELIGIOUS CHANGES AT PUBERTY. 

As womanhood unfolds, other changes occur besides 
those of the body. The girl is in a state of restlessness and 
of nerve irritability; her mind is confused with feelings of 
undefined longings and desires, and of vague dissatisfaction 
with all about her. She often tends to become morbid, 
fanciful, self-conscious and supersensitive, and her feelings 
are easily hurt. 

About this same time a change in the girl's religious 



THE PERIOD OF PUBERTY 103 

nature may be noticed. Mothers and Sunday-school teachers 
should fully understand this change, that they may guide 
the girl aright through this epoch in her spiritual being. 

The Phenomena of Religious Changes. — It is at this 
period, between the innocence of childhood and the fixed 
ideas of maturity, while the girl is yet impressionable and 
has already capacity for spiritual insight, that those ap- 
parently sudden changes of character in the spiritual life, 
known as conversion, usually occur. 

Sometimes the changes are gradual rather than sudden. 
The ideas of God and duty and religious observance, which 
during the earlier years may have been external to the child, 
having been embodied in precept or custom or in her own 
playful imagination, now, during the period of adolescence, 
take root in her life and have a vital significance; they be- 
come her own. 

The majority of girls at this time go through a period 
of storm and stress. They have a sense of incompleteness 
and imperfection; often they become brooding, depressed 
and morbidly introspective. Many doubts arise to distress 
them; there is a constant friction against their surround- 
ings. This is the most important stage of these changes; 
on its outcome the future religious attitude of the girl de- 
pends. Ill health and want of proper guidance at such a 
time are responsible for many cases of religious indifference. 

THE MOTHER'S DUTY. 

The duty of the mother is plain. Dr. Capp says : 
"The daughter is fortunate whose mother makes their 

intercourse a sympathetic companionship, especially at the 

age of puberty, when those changes in body and mind take 

place which develop the girl into a woman. 

"Of the changes in her body no one can speak to her 

better than a mother; but it will call for infinite tact and 



104 THE PERIOD OF PUBERTY 

the nicest judgment to so discuss them that maiden modesty 
and the charm of feminine instinct be not disturbed, and 
that proper hygienic considerations shall be inculcated. 
Certainly, the child should not be left to derive knowledge 
upon such subjects from servants or chance friends, who 
are not likely to be properly informed. It is not a time 
calling for alarm. The whole process is physiological, a 
growth and development according to the laws of nature; 
no new thing is happening." 

Sound practical advice in this connection is also given 
by Dr. Jane Walker: 

"Mothers and guardians of girls should obtain their 
entire confidence with regard to their monthly functions; 
it will save much misery, both to body and mind. 

"Here let me say that it is the duty of a mother to be 
open with her girl in this connection. When, from the 
changes that are occurring in the girl's body, her mother 
suspects that menstruation is about to take place, it is her 
duty to tell her what lies before her. What she will say 
will vary with the daughter's age, and also with the extent 
of the mother's own knowledge. If the latter has some 
acquaintance with physiology and natural science, she will 
be in a better position with regard to this question than 
one who has had no scientific teaching at all. Probably 
the simplest plan is to draw the girl's attention to the 
various signs of approaching womanhood, and then to tell 
her that this is one of them. In whatever way the com- 
munication is made, it must not be omitted, for no one can 
realize the shock endured by a perfectly ignorant girl on 
experiencing her first monthly period. Many of the ills 
suffered in later life are traceable to neglect and ignorance 
at this time. Moreover, if the mother does not herself tell 
the girl, someone else will probably do so, and the com- 
munication may be made with coarseness, which will have 



THE PERIOD OF PUBERTY 105 

an injurious effect on the girl's character. A mother should 
at this period of her life be a girl's best friend, with whom 
she feels there can be no reserve. " 

THE HYGIENE OF PUBERTY. 

During this trying period of her life, the child should 
be kept free from all excitement. She should spend a great 
deal of her time out of doors, playing various games, with- 
out becoming fatigued with too much exercise. Light oc- 
cupations will give her something to occupy her mind and 
take her thoughts off herself. She should have plenty of 
sleep, nine hours at least, but she must not be permitted to 
lie in bed after waking in the morning. 

During the menstrual period the daughter should re- 
ceive special care and attention. She needs quiet and rest 
and must not apply herself too closely to her studies. The 
hygienic management of menstruation itself is considered 
in detail in the following chapter. 

The Mother or Physician Should be Consulted Without 
Hesitation. — Dr. Button emphasizes that, as the girl ap- 
proaches puberty and is instructed regarding what is about 
to occur, it must be impressed upon her that her mother 
and her physician are her confidential advisers, either of 
whom she can freely consult regarding any trouble with the 
menstrual function, without being considered at all im- 
modest; that the subject is a sacred one, which she may 
discuss freely with her mother or physician for the purpose 
of information and advice, and maintain her dignity and 
modesty; but that to discuss it lightly with companions, 
in jest, is improper, immodest and vulgar. 



CHAPTER X. 
THE MONTHLY PHENOMENA. 



Ovulation. Menstruation. Time of onset and cessation. Character of the 
menstrual discharge. Duration of the flow. Quantity of the discharge. 
Other symptoms exhibited at this period. The menstrual interval. Pain 
during menstruation. Connection between menstruation and ovulation. 
Vicarious menstruation. The hygiene of the menstrual period. 



"The common ingredients of health and long life are : 
Great temp'rance, open air, 
Easy labor, little care/' 

— Sir P. Sidney. 



E 



VERY month there occur in a woman two phe- 
nomena, menstruation and ovulation. Neither is 
B3S2I dependent upon the other although they usually, 
but not always, occur at the same time. Ovula- 
tion, however, may be present several years before men- 
struation begins. 

THE PHENOMENON OF OVULATION. 

The ovary has been described as a gland secreting eggs. 
These eggs or ova develop one at a time. At regular in- 
tervals the most mature egg or ovum swells to the size 
of a pea or cherry and bursts through the wall of the ovary. 
This occurrence is known as ovulation, and takes place once 
a month during the period from puberty to the menopause. 
This period lasts on the average from the fourteenth to 
the forty-fifth year, although it has begun as early as the 
ninth and has ended as late as the fifty-ninth year. Ovu- 

106 



THE MONTHLY PHENOMENA 107 

lation may begin before menstruation, as has been said, and 
may cease before the menopause. 

When the ovum is discharged from the ovary, it en- 
ters the funnel-shaped outer end of the Fallopian tube and 
travels through this tube into the uterus. 

Connection Between Menstruation and Ovulation. — 
Although there is no direct connection between the two, 
menstruation and ovulation depend upon a common cause, 
being due to the same periodic nervous impulse. As a rule, 
the ovum is discharged at the height of the menstrual con- 
gestion, but it may leave the ovary at any time during the 
menstrual interval. 

THE OCCURRENCE OF MENSTRUATION. 

About the same time the ovum is discharged, a change 
takes place in the lining membrane of the womb. This 
becomes swollen and congested, due to an increase in the 
number and size of the blood-vessels. 

When Conception Occurs. — If the ovum, in its journey 
through the tube, should be impregnated by a sperma- 
tozoon or male cell which has worked its way up from the 
vagina, it becomes attached to the wall of the uterus. In 
this case the swollen and congested mucous membrane con- 
tinues to develop and helps to form the coverings for the 
ovum or egg with its contained embryo or unborn child, 

When Conception Does Not Occur. — If, on the other 
hand, the ovum is not impregnated, the new and dilated 
blood-vessels rupture, filling the uterus with blood. The 
uterus thereupon contracts and expels the blood. This 
monthly discharge of blood from the womb is known as 
menstruation. 

Time of Onset and Cessation of Menstruation. — In the 
preceding chapter menstruation was shown to be the prin- 
cipal event of puberty. It begins in this country at the 



108 THE MONTHLY PHENOMENA 

fourteenth year but the time of its first appearance is in- 
fluenced by the factors already mentioned. 

The menstrual flow usually ceases about the forty-fifth 
year, but it may stop before a woman is forty. On the 
other hand, it often continues beyond the forty-fifth year. 
The period at which it ceases is known as the menopause 
or "change of life." A chapter is devoted to the considera- 
tion of this important epoch. 

Character of the Menstrual Discharge. — The menstrual 
discharge consists chiefly of blood, but contains mucous 
secretion from the glands of the uterus and vagina. It is 
dark in color. As a rule it should not clot. A peculiar 
odor is imparted to it by the secretions of the glands of 
the vagina. 

Duration of the Flow. — The normal duration of the flow 
is from two days to a week. It rarely lasts less than three 
days. After the bloody flow has ceased it is commonly 
followed for a day or two by a mucous discharge or leu- 
corrhea. 

Quantity of the Discharge. — The amount of fluid dis- 
charged is given by Penrose as from two to nine ounces, 
and by Hirst as four to six ounces. It is seldom measured 
accurately. Instead, it usually is estimated by the number 
of napkins worn in twenty-four hours and is considered 
excessive if the napkins must be changed more than three 
times a day. The flow is greatest during the first two or 
three days and then grows less until it ceases. 

Other Symptoms Exhibited at this Period. — A woman 
usually experiences at this time a feeling of weight and 
heaviness in the generative organs, caused by their con- 
gestion and swelling. There is also a state of more or less 
nervous excitability, depending, as a rule, upon the woman's 
temperament. A nervous person is usually made worse at 
such a time. The breasts usually swell and may even 




A TIRED MOTHER AND HER BABE. 

After her hard day's work the weary mother is more ready for 
sleed? than her baby whom she has just put to bed. 



THE MONTHLY PHENOMENA 109 

secrete milk. The neck becomes enlarged through the 
swelling of a gland that lies just above the breast-bone. 
Sometimes the tonsils also become swollen; a singer may 
thus lose her voice at such a time. The heart usually beats 
quicker and more forcibly. The skin becomes redder from 
an increase of blood and may be flushed at times. Dark 
rings appear under the eyes and brown patches, known as 
liver spots, may show upon the skin. 

The Menstrual Interval. — Twenty-eight days usually 
elapse from the beginning of one menstrual period to the 
beginning of another. The menstrual interval, however, 
may vary within the limits of health. The flow sometimes 
occurs with regularity every two, three or five weeks. In 
the first instance the flow may be normal in amount every 
four weeks but scant at the alternate periods. 

Irregularities often occur when the general health is 
poor and when certain diseased conditions are present. 
These are discussed in a subsequent chapter. 

Pain During Menstruation. — A normal menstruation is 
painless. When pain is suffered before, during or after the 
menstrual period, it is an indication that there is something 
wrong with the general health, or with the local condition. 
The subject of painful menstruation and the methods for its 
relief are treated in the afore-mentioned chapter. 

VICARIOUS MENSTRUATION. 

The name vicarious menstruation is given to the dis- 
charge of blood at the menstrual period from some part 
of the body other than the uterus. This bleeding may 
come from the nose, the throat, the lungs, the stomach, 
the bladder, or the rectum and anus. It may occur in addi- 
tion to the normal flow. It is a rare condition, though as a 
rule of no serious import, being usually found in debilitated, 



110 THE MONTHLY PHENOMENA 

nervous women. In some cases, however, it is indicative of 
defective development. 

THE HYGIENE OF THE MENSTRUAL PERIOD. 

It is important that a woman should, so far as possible, 
have rest and quiet while menstruating. Especially is this 
true during the earlier years, when the mental and physical 
disturbances of puberty occur. Rest in bed is desirable, 
though not essential except in the very nervous. In every 
case all mental and physical work should be reduced as 
much as possible. A woman must be careful to avoid heavy 
lifting, over-fatigue in walking, too long standing, riding 
a horse or wheel, dancing and participating in violent 
sports during this period. Not only must she not indulge 
in sea bathing, but she cannot use cold water in any way — 
as tub, shower or sponge bath. 

All the hygienic rules given in the early chapters of this 
book are to be closely followed. 

In regard to the mental and nervous symptoms that 
may occur at such a time, Dr. Walker gives the following 
excellent advice: 

"Watch yourself carefully during these periods, and 
if you observe that you are unusually irritable, keep a 
tighter grasp on your self-control and try to appreciate the 
fact that you are not quite your best self. 

"If the world looks dark and people appear unfriendly, 
remember that you are being influenced by your physical 
condition, and do not pass judgment until you are feeling 
more nearly normal. You will then generally find that the 
world is just as bright and your friends are just as loyal as 
you had believed them before." 



CHAPTER XI. 
PURITY. 



Tfcs danger of silence. A mother's responsibility. What constitutes purity. 
A mother's duty to her daughter. To preserve true modesty and inno- 
cence. The dangers of secret vice. Hygiene as a prevention and treatment 



'Love Virtue, she alone is free ; 
She can teach thee how to climb 
Higher than the sphery clime ; 
Or if Virtue feeble were, 
Heaven itself would stoop to her." 

— Milton. 



THE DANGER OF SILENCE. 

BARENTS seldom realize that silence in regard to the 
matter of purity is fraught with the greatest danger 
to their children. They naturally feel some hesi- 
tancy and diffidence about broaching so delicate a 
subject. In their cowardice they frequently delude them- 
selves with the thought that possibly their child will escape 
learning of the evils existing in the world. 

But as a mother, writing in a leading popular magazine, 
some years ago said: 

A Mother's Responsibility. — "A knowledge of the utter 
corruption of human nature must in some degree reach the 
most sheltered woman of the present day, and it lies with 
every mother to accept the responsibility of seeing that it 
comes in the right way. If the alternative were between 
the knowing and not knowing of certain things on the part 

in 



112 PURITY 

of young girls, a mother might feel a natural pang at the 
thought of disturbing the vestal purity of the girlish imag- 
ination; but it is usually a very different alternative from 
this. The choice lies too often between knowing the right 
things and knowing the wrong — between looking at the 
most solemn realities of life in an earnest, reverent spirit, 
or making them the subject of mysterious and giggling con- 
fidences, and doable entente, though mothers may fondly 
dream otherwise. It is quite time that we women and 
mothers should face this question squarely, and that we 
should come to a true idea of what constitutes purity. 

What Constitutes Purity. — "Purity means spotlessness, 
not mere ignorance. It is a mental poise — that attitude 
toward evil which can only be taken and maintained where 
a knowledge of evil exists. It is not what one knows that 
constitutes impurity, but what one loves. * * * * 

A Mother's Duty to Her Daughters. — "It is an immense 
advantage to a woman to have made her children her com- 
panions. The. habit of talking with them and explaining 
difficulties of various kinds will open the way for such teach- 
ing as this, and if, in addition, she has informed herself in 
scientific matters, so that she can lead the way from phys- 
iological botany to human physiology, she will find the 
familiarity with scientific terms and the habit of dealing 
with the subject impersonally a great aid. 

"When a natural and healthful curiosity is met by a 
frank and simple statement of facts, the greatest danger is 
avoided. All temptation to discussion of these matters 
among girls is removed. Knowledge, instead of weaken- 
ing and corrupting the character, really strengthens and 
purifies, if it be the right kind of knowledge, rightly given. 
There must be a pure and right way of looking into what- 
ever God has ordained. Let us seek until we find it, and 
then gently guide our daughters till they find it too, ,, 



PURITY 113 

These same ideas are expressed by Dr. Capp, in his little 
book on "The Daughter," in which he says : 

TO PRESERVE TRUE MODESTY AND INNOCENCE. 

"To preserve the charm of true modesty and innocence, 
it is safer for a girl that she be instructed concerning the 
requirements of personal purity, rather than be allowed to 
grope amid chance experiences and to run the risks of un- 
friendly influences. Experience is the only teacher for all, 
but in many things the lessons may be taken at second hand, 
and the wise do well to profit by the experiences of others. 
Although it may be a difficult duty to perform, no careful 
mother will neglect to properly instruct her daughter in 
matters relating to the sexual nature. Thoughts upon this 
subject cannot be avoided, but will arise as mind and body 
develop, and they should be wisely and intelligently di- 
rected in confidential talks skillfully planned and discreetly 
managed by the mother. 

"Sexual matters are not motives and aims in life, but 
they imperiously mingle with and influence all motives and 
aims. They are inseparable from existence, and though 
important, must be made subordinate, and though irre- 
pressible, must be held in subjection. To ignore them is as 
fatal to happiness and success in life as to allow them to 
be the objects of chief pursuit. To underrate their influence 
is a great mistake; it must be justly appreciated in order 
to maintain an effective control by the stronger forces of 
the intellect and the will. Let it be remembered how large 
a portion of human misery results from the disorderly ani- 
mal passion. Much of this should be withheld from the 
knowledge of the young, but enough, for their own safety, 
may be pointed out by the mother, and be accompanied by 
such admonitions as seem suitable in each individual case. 

That the duty is a delicate one and is surrounded by diffi- 
8 



114 FTJKXTY 

culties affords no reason for its avoidance, but rather calls 
for redoubled tact and a superior skill, which will not fail 
of their aim when instigated by the loving instinct of a 
true mother's heart. 

"The subject is obviously not one for promiscuous dis- 
cussion, but nothing is gained in private by veiling it with 
mystifying reserves and ingenious evasions, which serve 
[ often to keep smoldering an unsatisfied curiosity that had 
better be laid to rest by a little necessary plain and whole- 
some truth. Here, as upon many other social subjects, 
greater safety to the individual and to the community lies 
in knowledge tending to wisdom rather than in ignorance, 
if only the mind is maintained in a proper attitude toward 
the facts." 

THE DANGERS OF SECRET VICE. 

Fearing to suggest a habit of which the child may 
have no previous knowledge, a parent usually fails to 
warn the child of the dangers of secret vice. Few real- 
ize how prevalent is this evil, and how many the oppor- 
tunities for learning of it. Schools, especially boarding 
schools, have long been the chief breeding places for bad 
habits. A servant, and especially the nurse, is frequently 
the instructor. A child may accidentally produce a pleas- 
urable sensation and voluntarily repeat it without being 
aware that she is doing wrong. This is especially liable to 
occur in the presence of irritation or of any physical defect. 
Children can dissemble so skillfully that they may never be 
suspected. Because a child looks innocent is no indication 
that it is so. A mother must never allow her love to blind 
her to possible imperfections in her child. It is an injus- 
tice to the child not to warn her of the pitfalls into which 
she may stumble. Perfect frankness regarding so frequent 
a cause of general ill-health, chronic invalidism, and some- 
times even insanity, will save a girl much physical and 



PURITY 115 

mental suffering as well as moral loss. Even though the 
results may not be as grave and irremedial as is often 
thought, they are serious and often lasting. A mother's 
duty is plain. 

Hygiene as a Prevention and Treatment. — To prevent 
as well as cure improper habits or tendencies, the child's 
thoughts should be diverted from sexual matters and pre- 
vented from centering upon herself. All associations and 
modes of life which have such a tendency should be discoun- 
tenanced. A wise supervision must be exercised over books 
and companions. Busy occupations furnish a means of 
monopolizing the time and keeping both body and mind 
from running into morbid states. Healthful amusement and 
judicious exercise are important; outdoor life and interests 
should be encouraged. The girl should go to bed whole- 
somely tired, so that she may promptly fall into a sound 
sleep, undisturbed by dreams. 



CHAPTER XII. 
MARRIAGE AND COURTSHIP. 



The views of various thinkers. The origin of marriage and the family. Mar- 
riage customs among different people. Courtship according to modern 
ideas: in Continental Europe, in England, in America. Love the basis for 
marriage. The nature of love, according to the poet and the philosopher. 
Passion versus affection. Love as a passion is transient. Passion may be 
followed by a steadier sentiment. Marriages based on passion are unhappy. 
Province of courtship to cultivate mutual esteem and friendship. The 
money question should be considered before marriage. A wrong standard 
of requirements. Marriage for position or wealth. Sincerity during court- 
ship. The training of a girl for wifehood. Qualities needed by a working- 
man's wife. The proper age for marrying. The danger of early marriages. 
A mutual understanding about details necessary before marriage. 



'Hail, wedded love, mysterious law, true source 
Of human offspring." — Milton, 



||1t1N a book dealing with a woman's life, so important an 
5g» ■ event as marriage should not be passed over with- 
sIBsj out some mention. Apart from its causal relation 
to many physical ills, married life has an influence 
upon a woman's nervous and mental conditions through 
which it may affect the health. Much of the misery and un- 
happiness that comes after marriage might be prevented by 
a calm reflection beforehand on its duties and responsi- 
bilities, and by a mutual interchange of ideas during the 
period of courtship. In the belief that a study of marriage 
from the historical and philosophical standpoint may make 
a woman better fitted for becoming the head of the house- 
hold and the mother of a family, the author has collected the 
views of various thinkers of different countries and periods, 

116 



MARRIAGE AND COURTSHIP 117 

of which he can say with Montaigne, "I have here made only 
a nosegay of culled flowers, and have brought nothing of my 
own but the string that ties them. ,, 

THE ORIGIN OF MARRIAGE AND THE FAMILY. 

The institution of marriage has its origin in a law exist- 
ing throughout the animal kingdom for the perpetuation of 
the species. 

Among many of the animals the parents live together 
for a longer or shorter period, but among others no such 
conjugal tie is recognized. As a rule, however, the mother 
is attached to her young and provides for them until such 
a time as they can look after themselves. 

In the human race are seen all the gradations from the 
promiscuity of primitive peoples to the monogamy of 
modern civilized communities. From the necessary rela- 
tions of the father, mother and child to each other arises the 
family. Unable to live alone, the child requires both nourish- 
ment and protection; the former is supplied by the mother, 
the latter by the father. 

MARRIAGE CUSTOMS AMONG DIFFERENT PEOPLES. 

Marriage customs vary considerably in different parts 
of the world. Letourneau has described them in detail. 

Marriage by Capture. — The most primitive form is 
what is known as marriage by capture. This is practised 
among the natives of Australia and the surrounding islands 
and of the Philippines. The man captures a woman be- 
longing to another tribe and subsequently enters into a 
treaty with that tribe by which, after a certain ceremony, 
he is permitted to retain the woman as his wife. The mar- 
riage rites in Mongolia, and among the Esquimaux, are a 
form of simulated capture which takes place after the mar- 
riage has been arranged by the parents. The Esquimaux 



118 MARRIAGE AND COURTSHIP 

pretend to kidnap the girl. In Mongolia the woman in her 
bridal attire gallops off on a horse, pursued by the bride- 
groom and the wedding guests. 

Marriage by Barter. — Another form of marriage is that 
by barter, traces of which may still be seen in a number of 
civilized countries. In Africa the girl belongs to her 
parents, who in a friendly way barter her for an ox or for 
a cow. 

Among the Indians marriage is usually a commercial 
enterprise. The husband buys his wife, or, if a poor man, 
is obliged to work to gain her. He binds himself for a stated 
time to the girl's parents, for whom he must hunt, dig- and 
scoop out canoes. In some tribes a certain period of servi- 
tude was always customary. The husband was obliged to 
give a tenth part of the game that he killed to the father 
and mother of his wife. 

In ancient Greece and Rome the girl was bought by 
presents or by services rendered to the father. At a later 
period the father gave her a dowry but still might marry 
her without consulting her wishes. 

In Scandinavia also and in certain parts of Germany 
the marriage was no more than a sale of the young girl, the 
husband having to buy her from the father. But by de- 
grees instead of this method that of a dowry paid by the 
woman was substituted. 

COURTSHIP ACCORDING TO MODERN IDEAS. 

With the progress of civilization the condition of 
woman has improved. The woman has acquired a certain 
independence and in most civilized countries no longer is 
married without her choice being consulted. For many cen- 
turies the prospective husband has had to woo her and ob- 
tain her consent. Thus the period of courtship has arisen. 
Customs vary in different countries as to the manner of 



MARRIAGE AND COURTSHIP 119 

courtship and even as to the social intercourse between 
young unmarried persons of opposite sexes. 

Courtship in Continental Europe. — On the continent of 
Europe the match is usually determined upon or at least 
sanctioned by the parents before the young folks meet. As 
a rule a man may not call on a girl until he first through a 
third person asks to marry her, and only in the event of the 
consent of her parents being obtained will he be permitted 
to see and speak to her. 

The English Idea of Courtship.— -In England oppor- 
tunities for social intercourse are less restricted so that 
young people may be able to study and know each other well. 
It is not customary, however, for a man to be seriously at- 
tentive to a girl for an indefinite length of time without de- 
claring his affection or at least making his intentions known 
to the father. 

Social Intercourse in America. — Still greater advan- 
tages and liberty of choice are afforded in America. Here 
men and women may form close friendships and learn to 
know each other's thoughts and hopes without necessarily 
looking forward to a closer tie. Thus a more intelligent 
choice is made possible. 

Choice of a Life Partner. — The duties of marriage, says 
a French philosopher, begin before marriage. They begin 
with a mutual choice of the man and the woman. This 
choice should not be made lightly without thought, but 
should be determined by a serious and noble conception of 
the duties and end of marriage. 

LOVE THE BASIS FOR MARRIAGE. 

All writers agree that without love no one should marry. 
"Never marry but for love," was William Penn's injunction, 
"but see that thou lovest what is lovely." Miss Mulock can 
understand women's renouncing love, or dying of it, or 



120 MARRIAGE AND COURTSHIP 

learning to live without it; but marrying without it, either 
for "spite," or for money, necessity, pity, or persuasion, is 
to her utterly incomprehensible. She says, "Out of duty or 
gratitude it might be possible to work, live, or even die for 
a person, but never to marry him." 

THE NATURE OF LOVE. 

The Poet's View. — From earliest times love has been 
the theme of poets including the Hebrew King Solomon, the 
Grecian Homer and the Roman Virgil. In "The Lay of 
the Last Minstrel" Scott gives the following description: 



True love's the gift which God has given 
To man alone beneath the heaven : 

It is not fantasy's hot fire, 

Whose wishes soon as granted fly ; 

It liveth not in fierce desire, 

With dead desire it doth not die ; 
It is the secret sympathy, 
The silver link, the silken tie, 
Which heart to heart and mind to mind 
In body and in soul can bind." 



The Philosopher's View of Love. — Somewhat different 
from the poet's picture of love is the philosopher's definition. 
Herbert Spencer says that love is habitually spoken of as 
though it were a simple feeling, whereas it is the most com- 
pound, and therefore the most powerful, of all the feelings. 
To the physical elements forming the nucleus of the whole 
are added the feelings produced by personal beauty that con- 
stitute simple attachments. With these there is united the 
complex sentiment termed affection, which is here greatly 
exalted. Then there is the sentiment of admiration, respect 
and reverence, which in this relation becomes in a high de- 



MARRIAGE AND COURTSHIP 121 

gree active. There comes next the feeling called the love of 
approbation, which is gratified in a degree passing every 
other experience by being preferred above all the world and 
that by the one admired above all others. There also is 
added that indirect gratification which results from the pref- 
erence being witnessed" by others. Further, the allied emo- 
tion of self-esteem comes into play, being agreeably excited 
by the proof of power at having succeeded in gaining such 
attachment from and sway over another. There is also the 
pleasure of possession, the two belonging to each other. In 
addition the relation allows of an extended liberty of action 
and of an exaltation of sympathies which doubles one's own 
pleasures and adds to them the pleasures of another. These 
all greatly exalted unite to form the mental state we call love. 

PASSION VERSUS AFFECTION. 

Love as a Passion is Transient. — It is universally recog- 
nized that love considered merely as a passion usually has 
but a short duration. Like all other passions it tends 
to be changeable, transient and accidental. It generally 
passes away with beauty and youth, and seldom outlives the 
freshness of physical charms. In the opinion of Walter L. 
Sheldon, the distinguished ethical culturist, that sentiment 
which the poet tells of, and which is sung or presented in 
music, or pictured in the story, is simply the portrayal of 
a spasm in life — beautiful and entrancing as it may be. He 
believes that in three-fourths of the cases, if not in nine- 
tenths of them, it is all involved in a period of one, or two. 
or three years, perhaps only the few months before marriage 
and the few months after. 

PASSION MAY BE FOLLOWED BY A STEADIER SENTIMENT. 

Sheldon does not consider this sentiment by any moans 
the only lofty aspect of the love-passion or of the love-union. 



122 MARRIAGE AND COURTSHIP 

In a course of lectures on the subject of marriage he said: 
M That spasm may be only a short phase through which the 
deep feelings may have to pass — or it may not be an essential 
part of the experience at all. Over and over again, after the 
passion has subsided, it would seem as though the union were 
at an end. But where it was an actual attachment, something 
more than a mad ebullition of passion, there has come little 
by little another and steadier sentiment which has gradually 
found its place and held on to the end. Again and again there 
has been a tragedy because the two people have not waited 
for this new phase of affection to arise. They had thought 
their love was dead only because the transient excitement was 
over ; whereas in reality the real love-sentiment may be only 
just getting started. Many of the happiest unions which have 
ever existed have probably been between people who went 
through this experience of disappointment because of the 
illusions which had been fostered mistakenly in their youth. 
Time must be given for a further reunion to arise on a 
spiritual plane, but where prose and poetry must jostle 
together in the daylight of stern reality. 

The Second Experience of True Affection. — "In that 
second experience it is no longer the sentiment-standpoint 
of two souls with a single thought or the two hearts that 
beat as one — a fantastic impossibility — it is an awakening to 
the actualities of life, and to all its possibilities. An affection 
may then arise which can admit of imperfections in the one 
for whom it exists, which can cling in spite of weakness and 
selfishness and caprice. And in this kind of an affection 
where the two may be only imperfectly united, there is a 
possible realization of each in the other by which the life of 
each does become more complete in the other. And that very 
completion and fullness may come in putting up with the 
other's imperfections, by a union for better and for worse." 



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MARRIAGE AND COURTSHIP 123 

Romantic Love Cannot be True Love. — Felix Adler 
believes that a great deal of the disappointment in marriage 
may be attributed to false expectations founded upon the 
romantic idea of love, the false idealization of the beloved 
person. To attribute perfection to the object of love is 
characteristic of the romantic idea, which is inspired by the 
desire of each to enjoy the perfection of the other. This 
indulgence in delusions and dreams he objects to, because it is 
false ; and falsehood, especially in the fundamental relations 
of life, is sure to enact its penalties and to bring reaction in 
after years. There are some persons, he admits, especially 
women, who have the art of obstinately adhering to their 
illusions in defiance of their better knowledge. But in general, 
he says, when it appears that the idol has feet of clay, then 
one of two things must happen; either the marriage continues 
intact while love is dead, supported by the force of custom or 
by fear of exposure, and becomes a sort of lacklustre fellow- 
ship, a weary chain that is dragged to the end with what 
patience one can command; or else, in bolder and more reckless 
natures, the idea to meet the embodiment of one's ideal some- 
where, persists, and the attempt is made to find outside of 
marriage, in unwholesome and illicit ways, the satisfaction 
which the marriage relation fails to bring. For these reasons 
he believes that romantic love cannot be true love. 

Marriages Based on Passion are Unhappy. — Franklin 
believed that headstrong motives of ungoverned passion result in 
unhappy marriages. He wrote: " Passions are extremely tran- 
sient and unsteady, and love, with no other support, will ever be 
short-lived and fleeting. It is a fire that is soon extinguished, and 
where there is no solid esteem and well-cemented friendship to 
blow it up, it rarely lights up again, but from some accidental 
impulses, by no means to be depended upon, which a con- 
trariety of tempers, the fatalities of sickness, or the frowns, 
of fortune, may forever prevent, as age most certainly will. 



124 MARRIAGE AND COURTSHIP 

"What has been observed seems to point out that a 
blind, a sudden and intoxicating passion has a natural 
tendency, under its own direction, to occasion unhappy mar- 
riages, and produce scenes of grief and repentance." 

Province of Courtship to Cultivate Mutual Esteem and 
Friendship. — "Friendship and esteem," Franklin says, "are 
derived from principles of reason and thought, and when 
once truly fixed in the mind are lasting securities of an at- 
tachment to our persons and fortunes ; participate with, and 
refine all our joys ; sympathize with, and blunt the edge of 
every adverse occurrence. However it may be in common 
life, there certainly cannot be any steady or lasting happi- 
ness in a married one where a mutual esteem and friend- 
ship of the strongest and noblest kind does not subsist. Let 
it therefore be the sacred business of our courtship to culti- 
vate one, and on no account engage ourselves in wedlock 
without it." 

THE MONEY QUESTION SHOULD BE CONSIDERED 
BEFORE MARRIAGE. 

"How much, or how little a fortune will content us," 
writes Franklin, "depends chiefly on our way of thinking. 
Be this as it will, it should seem very proper before all mar- 
riages for both parties to know truly and fairly what they 
have to expect on this head, and seriously to consider with 
themselves whether it will be sufficient so far to answer 
their desires, as to prevent future murmurings and anxieties, 
and prudently allow them to enjoy life as they intend. All 
deceit herein should be carefully avoided; we may otherwise 
impose on ourselves and ruin all our future felicity." 

A WRONG STANDARD OF REQUIREMENTS. 
Many men are prevented from marrying, and many 
marriages are made unhappy, because the woman often has 



MARRIAGE AND COURTSHIP 125 

been accustomed as a daughter to comforts and luxuries 
which become her standard of requirements for all time. 

Only Those in Equal Circumstances Can Marry Under 
Such a Standard. — This wrong standard of requirements, 
according to Sheldon, works pathetically in making it in- 
evitable that only those persons accustomed to the same 
plane of luxuries in their homes may join in the marriage 
relationship. The man most adapted to a woman frequently 
dare not think of her, because he is in humbler circumstances 
and would not be able to sustain her on the plane in which 
she has been living. Thus the actual freedom of choice is 
restricted. 

Marriage for Position or Wealth. — A consideration be- 
fore marriage of social position is almost as important as 
that of the money question, for the marriage of persons from 
different planes of society may lead both to embarrassment 
and unhappiness. When, however, too much attention is 
paid to these matters the marriage seldom results happily. 
Franklin says that the finer sentiments are never felt or 
known in that alliance where interest and fortune only are 
considered. Envy may be raised among the weak and silly, 
but pity and contempt among the wise and judicious. The 
slaves to dross can never be animated with a spirit of a gen- 
erous, an elevated and inflexible friendship. "Gold is their 
idol," he declares, "'tis that they wed." 

SINCERITY DURING COURTSHIP. 

One of the most freqent causes of unhappiness in mar- 
ried life is the false view of one's mind and disposition 
presented during courtship in order to win the affections. 
Franklin considers the masking of our tempers and appear- 
ing what we really are not to be a most dangerous folly, and 
an imposition highly culpable, so that he is really at a loss 
to judge whether the absurdity or iniquity of such a scheme 



126 MARRIAGE AND COURTSHIP 

be the greatest. "In such a case," he says, "we have raised 
and supported an affection by false appearances ; when those 
are seen through, as most certainly they will be, what title 
have we to love or friendship? None, and consequently no 
prospect of social happiness. 

"Let us, my friend, on the contrary, observe a religious 
sincerity, appear in our native characters, undisguised and 
unaffected. If under those we gain esteem and friendship, 
our prospects of maintaining them are as secure as our own 
minds and dispositions may be lasting. Let us be outward- 
ly what we really are within, and appear in such a character 
as we steadfastly design to continue. Hereby we shall lay 
a strong foundation for our future happiness in marriage. ,, 

THE TRAINING OF A GIRL FOR WIFEHOOD. 

Housekeeping is not a simple undertaking, but a most 
complicated one, which cannot be successfully taken up 
without previous training. The mother therefore should 
train her daughter in the management of the household by 
allowing her to exercise some of the duties and responsibili- 
ties connected with the house. 

QUALITIES NEEDED BY A WORKING-MAN'S WIFE. 

In order to elicit the opinion of the working classes on 
matters connected with their social condition, an English- 
man named John Cassell offered prizes for the best essays 
on various subjects. Louisa Bell, a seamstress and the 
widow of a factory hand, in her prize essay on "Indiscreet 
Marriages," says: "Working men are much too apt to 
choose their wives without any reference to their former 
domestic lives and habits. Bitterly enough sometimes they 
repent this precipitancy. A working-man's wife should 
have been well and diligently brought up by good parents. 
She should know how to perform every household duty, and 



MARRIAGE AND COURTSHIP 127 

be able to make or mend the clothes of the family. Her 
health should likewise be good. Ill-health and over-delicacy 
of constitution sound very interesting in some of the highly- 
strained fictions of which our working women are so fond; 
but in real, common, every-day life, strength and health in 
an operative's wife are beyond all sentimental notions of re- 
finement and beauty. . . . 

Economy in Dress. — "Neatness and a due attention to 
dress are not only commendable, but imperative on every 
woman, and man also; but dressing must not be carried be- 
yond the due bounds necessary to self-respect and the re- 
gards of others. A working woman's pride should be to 
possess a good stock of neatly made under-clothing; and a 
couple of gowns, or at most three, may then well suffice her. 
With economy these three gowns will last a long time. . . 

"Cleanliness and simplicity should be the height of their 
ambition instead of the cheap finery which in a week's space 
becomes soiled and unfit to be worn. 

"Very few of the working class of women, unless dress- 
makers by trade, know how to make their own attire.* Many 
are perfectly helpless in this respect. The sums they are 
compelled to pay in putting out such work would educate 
the children, and provide better fare for the family. It is no 
excuse to urge, as many do, that they pinch themselves and 
families in food or firing to provide fine clothes. Working 
people require good nourishment, and to subtract from a 
husband's dinner to buy a new bonnet or a new dress is no 
apology, but adds to the folly and selfishness of a passion 
which at all risks must be gratified 

Training in Marketing and Cooking. — "Marketing is 
another art — for art it is — in which a workman's wife is 
woefully deficient; and, lacking it, her weekly money will 

♦This was written of the English working woman. It probably is not 
true of the American factory girl of today. 



128 MARRIAGE AND COURTSHIP 

seldom go far, or yield satisfactory returns. She buys in- 
ferior meat, because she can get more for her money, forget- 
ting that it wastes in proportion to its inferiority. She buys 
the bony portions of an ox or sheep, because it is apparently 
cheaper, and never takes into account the dead loss of the 
bone, for the very slender portion of skill she possesses in 
cooking is insufficient to teach her how to convert even bones 
into nutriment. In this latter accomplishment she has 
neither experience nor any desire to gain it. She boils her 
stews, and makes them hard and indigestible. She cannot, 
in fact, cook even a potato fit to be eaten, and is utterly in- 
competent to render the cheap parts of meat nourishing and 
tender. Yet such knowledge goes far to render the working 
class man's home replete with comfort and happiness. 
Savory meals and palatable food are regarded by all, rich or 
poor, as one of the elements of domestic comfort — and not 
unreasonably; wanting these, the workman surely seeks 
solace in the tap-room or the liquor-vaults." 

THE PROPER AGE FOR MARRYING. 

Law and custom in different countries do not agree 
upon any one age as being the most suitable for marriage; 
opinions vary greatly. Speaking from the physiological 
standpoint, it may be said that marriage should not take 
place until the full growth and development has been at- 
tained. The idea of the ancients, which is still held by peo- 
ple in certain countries, that with puberty a woman enters 
upon the child-bearing period is a mistaken one. A woman 
should not marry before she has reached her twentieth year, 
nor a man before the age of twenty-four. It would be even 
better for a woman to wait until she is twenty-four, at which 
age she may be considered fully developed. 

Individuals who have not yet themselves reached ma- 
turity cannot possibly beget properly developed and healthy 



MARRIAGE AND COURTSHIP 129 

offspring. This is true of man and animals alike. No breeder 
permits his stock, however healthy, to bring forth young be- 
fore they have arrived at maturity. The offspring of such 
are always small and weak. It is the common practice 
among fanciers to destroy the first litter of pups, as they are 
usually found to be sickly. 

THE DANGER OF EARLY MARRIAGES. 

In the human family, it has been noted from very early 
times that the children born of parents who have not them- 
selves reached maturity are wanting to a greater or less ex- 
tent in strength, stamina, courage and general develop- 
ment. Aristotle noticed that the children were puny and of 
small stature in those cities of Greece where it was the cus- 
tom for young people to marry before maturity. Montes- 
quieu observed in France that when fear of being sent to 
war caused great numbers of young people to marry long 
before the proper period, the children were small, wretched 
and unhealthy. To be called the child of a boy or girl has 
always been equivalent to being called a coward. This Mac- 
beth well knew when he exclaimed to Banquo's ghost : 

"What man dare, I dare 
Approach thou like the rugged Russian bear, 
. . . . or, be alive again, 
And dare me to the desert with thy sword ; 
If trembling I inhibit thee, protest me 
The baby of a girl. ,, 

Strahan says that a vast number of the children of the 
immature are born prematurely to the great danger of the 
imperfectly developed mothers; that a much larger per- 
centage of them are idiotic, dumb, blind, scrofulous, and 
otherwise imperfect and deformed than of the children of 
parents generally; that they have a less firm hold on life than 



130 MARRIAGE AND COTJRTSHXP 

the children of mature parentage, and that many succumb 
to scrofulous and nervous affections, a great number dying 
of convulsions before or during the period of the first denti- 
tion. As a class, such children are decidedly not long-lived, 
and those who do attain the age of maturity are generally 
delicate and under-sized physically, often obtuse and more 
or less dwarfed mentally, if not distorted, at least blunted, 
morally, and are wanting in spirit, energy and courage. 

The Misery Caused by Early Marriages. — The folly of 
early marriages may be seen in its economic aspect as well 
as in its physiological. Mrs. Bell writes : "It is no uncom- 
mon thing among the operative class to see a couple present 
themselves for marriage whose united ages do not amount 
perhaps to thirty-four years — the girl-wife sixteen, the boy- 
husband two years her senior. All the money they can col- 
lect or save is spent in making holiday on the wedding day. 
Their home is one poor room, void of all furniture, save a 
bed of the humblest description, a chair or two, and a table 
with one or two cooking utensils. The earnings of both — 
for in these cases the wife is generally employed at some 
of the slop-work so prevalent in London, work for which 
the very lowest amount of remuneration is given — can bare- 
ly sustain their mutual wants. When children come, what 
with the utter inexperience of the mother, and the reckless 
habits of the premature father, all speedily in that poor 
household becomes dirt, waste, confusion and misery. The 
young pair have known no youth, none of the freedom from 
\the yoke of care, which should be one of the especial 
privileges of that happy time; but all becomes faded, wan, 
spent. The gloom of middle age comes on, when life should 
be in its first promise of spring; and age ensues in the middle 
of existence — age and premature decay. Being the very 
nature of immaturity to be fickle, boys and girls rashly fancy 
they love; and not understanding the nature of true affec- 



MARRIAGE AND COURTSHIP 131 

tion, its endurance and devotion, without which it is not 
worthy of the name, they unite themselves in irrevocable 
bonds, grow soon after mutually weary and disgusted, and 
ultimately part even after dwelling together for years, hav- 
ing shared the precocious troubles which they have brought 
on their own hands." 

A MUTUAL UNDERSTANDING ABOUT DETAILS NECESSARY 
BEFORE MARRIAGE. 

There are many matters of importance in the married 
life which are seldom discussed beforehand. The man and 
woman are each in ignorance as to the other's views of many 
subjects until after the wedding day. Brutal instincts 
never before suspected may then be discovered, with result- 
ing unhappiness, discord and ill-health. Neglect to fully ac- 
quaint oneself beforehand with the other's opinions in regard 
to the married life is unfair to both. A way should be found 
— direct or indirect — of settling all questions before the ir- 
revocable step is taken. 



CHAPTER XIII. 

HEREDITY IN ITS RELATION TO 
MARRIAGE. CONSANGUINITY. 



Providing for the health of the unborn. Exchange of confidences. A physi- 
cian should be consulted. When these precautions are disregarded. Where 
the hereditary taint is slight. Drunkenness an obstacle to marriage. In- 
sanity and epilepsy a bar to marriage. Deaf-mutism in its relation to 
marriage. Instinctive criminality a form of degeneracy. Consumption a 
disease in which heredity is sometimes a factor. The marriage of syphi- 
litics. Consanguineous marriages. 

"The gods visit the sins of the fathers upon the children." 

— Euripides. 



I 



T is most unfortunate that, no matter how debased, 
crippled or deformed people may be, they are 
allowed to marry and become the parents of a 
suffering, helpless family. Judgment and common 
sense should always arise to prevent the union of those 
who are unfit, mentally or physically, for bearing children. 
Providing for the Health of the Unborn. — Dr. Richard- 
son said: "The first step toward the reduction of disease 
is, beginning at the beginning, to provide for the health of 
the unborn. The error commonly entertained, that mar- 
riageable men and women have nothing to consider ex- 
cept wealth, station or social relationships, demands cor- 
rection. The offspring of marriage, the most precious of 
all fortunes, deserves surely as much forethought as is be- 
stowed on the offspring of the lower animals. If the inter- 
marriage of disease were considered in the same light as 
the intermarriage of poverty, the hereditary transmission 

132 




THE BEDTIME PRAYER. 

Every mother should teach her child to scud up 
petition if it be only the beautiful and simple, 
11 Now I lay me down to take my shop, I pray Thee, Lord, my soul 

to keep." 



HEREDITY. CONSANGUINITY. 133 

of disease, the basis of so much misery in the world, would 
be at an end in three, or at most four, generations." 

Exchange of Confidences. — Strahan advises that all 
persons who contemplate matrimony, or to whom attention 
and overtures are being made with a view to marriage, 
should look upon a mutual exchange of confidences upon 
this matter of hereditary or family disease as absolutely es- 
sential, and that, too, at an early period of the intimacy, be- 
fore the affections have become deeply engaged. Too often 
knowledge of the existence of the family skeleton, when 
given at all, is only given when matters have gone so far 
that only those of strong will find it possible to give up 
the loved one because of an evil so distant and shadowy as 
this family taint appears to the eyes of the lover. 

A Physician Should be Consulted. — Before the mar- 
riage of a person in whose family there is an hereditary 
disease, a physician should be consulted and the whole mat- 
ter should be laid before him candidly and honestly. The de- 
cision of a competent physician should be accepted as final. 
The importance of adopting such a course cannot be em- 
phasized too strongly. 

Where these Precautions are Disregarded. — Untold 
misery is entailed by the disregard of such precautions. Stra- 
han thus describes the day of reckoning: "In some cases it 
comes very soon, as where the first-born's vacant face is 
scanned day after day, and the heart sinks as the terrible 
fact forces itself upon the parent that his child is an idiot, 
or where the young wife suddenly loses all that made her 
god-like, all that made her human, and the husband finds 
himself with a creature in his arms at which his soul re- 
volts. * * * * 

"But in many cases the evil day does not arrive until 
middle life; and then, when the fear once felt has worn 
away, when the deception practiced has faded from the 



134 HEREDITY. CONSANGUINITY. 

memory, and the grave admonition of the physician is for- 
gotten, the son in whom the father hoped to live again, 
the girl on whom the mother's heart is set, is torn from the 
family circle a raving maniac, a tortured epileptic, a drunken 
criminal, or, happily, a suicide. Then arise sad regrets, but 
it is too late; the laws of Nature have been ignored, gratifi- 
cation has been purchased, and the price must be paid. The 
sins of the fathers shall be visited upon the children/' 

Where the Hereditary Taint is Slight. — In addition to 
the cases in which the hereditary predisposition to disease 
is so decided that marriage should not be considered, there 
is a still larger class of those in whom the taint is so miti- 
gated that, with a properly selected partner, a fairly healthy 
family may be reared. If a member of a neurotic family — 
that is one in which insanity, epilepsy, drunkenness or 
suicide has at any time appeared—marries a healthy member 
of a healthy family, the tendency to nervous disease, if not 
too deeply marked in the parent, may be totally lost in the 
children. But when he marries into another neurotic 
family disaster will surely fall upon the luckless children. 
Even when the disease has appeared in but one or two 
members of the family it shows the existence of the ten- 
dency and will probably reappear in the children of such 
an unfortunate marriage. 

DRUNKENNESS AN OBSTACLE TO MARRIAGE. 

There is probably no disease or vice which causes 
deeper degradation in the individual and more acute suffer- 
ing in the family than drunkenness. It is the starting point 
of insanity, epilepsy, crime, and endless diseases in posterity. 

Idiocy is often due to the family taint of drunkenness, 
about twenty-five per cent, of the idiots being children of 
intemperate parents. In Norway, when the duty on liquor 
was removed and intemperance began at once to increase 



HEREDITY. CONSANGUINITY. 135 

among the people, idiocy increased 150 per cent, and in- 
sanity 50 per cent, among the children born during the next 
ten years. 

In the following family history, given by Morel, the 
degenerating effect of drunkenness upon the stock is well 
shown : 

First Generation. — Father, a drunkard. 

Second Generation. — Son, a drunkard. Was disgust- 
ingly drunk on his marriage day. 

Third Generation. — Seven grandchildren. First died 
of convulsions. Second died of convulsions. Third was an 
idiot at twenty-two years of age. Fourth, melancholiac, 
with suicidal tendency— became demented. Fifth, peculiar 
and irritable. Sixth, has been insane repeatedly. Seventh, 
nervous and depressed, and indulges in most despairing an- 
ticipations as to his life and reason. 

No woman should marry a confirmed drunkard; nor 
should she become engaged to the son of one until his dis- 
position and character have been most carefully inquired 
into. 

INSANITY AND EPILEPSY A BAR TO MARRIAGE. 

When insanity is inherited in any family, it usually 
appears in only one, two or three members of each genera- 
tion; but it may be transmitted to the next generation by 
those who do not themselves become insane. A person who 
at any time has been insane should never marry. A mem- 
ber of a family in which any mental disorder has appeared 
should not marry into another neurotic family. If, however, 
such a one be a man, and show no evidence himself of the 
family failing, he may sometimes marry into a healthy 
family with but a minimum of clanger to the offspring, al- 
though it were best not to run the risk of progeny. Such 
permission, however, can never be granted to a woman, as 



13b' HEREDITY. CONSANGUINITY. 

there are certain epochs in her life when the chances for 
losing her reason are very great if there be an hereditary 
taint of insanity in her family. 

Epilepsy may practically be regarded as an hereditary 
affection. Although at times it may seem to be brought on 
by an injury or fright or nervous irritation it seldom attacks 
one who does not inherit a neurotic temperament. In fact 
when there is insanity in a family, the children are liable to 
be epileptic. Consequently one subject to this disorder 
should not marry. 

DEAF-MUTISM IN ITS RELATION TO MARRIAGE. 

There are two classes of deaf mutes which must be care- 
fully differentiated before the question of marriage is con- 
sidered. In one family predisposition plays no part; in the 
other the disease is of an hereditary character. Where 
deafness has followed some injury to the organ of hear- 
ing before or shortly after the power of speech has been 
attained, it should not be a hindrance to marriage, as it 
is never transmitted. Deafness present at birth, however, 
is usually dependent upon some family defect, being a con- 
dition of degeneracy closely allied to idiocy. Clouston 
considers it a physiological sin that marriage between such 
persons should be legal. 

INSTINCTIVE CRIMINALITY A FORM OF DEGENERACY. 

The habitual criminal is an abnormal type of individual, 
the result of a family degeneracy. He is a moral imbecile, 
lacking the moral sense in the same manner as the idiot 
lacks intelligence. The hereditary character of this form 
of degeneracy, which is known as instinctive criminality, 
has been recognized from the earliest times. Like every 
family trait, it may be transmitted to all or only to some 



HEREDITY. CONSANGUINITY. 



137 



of the members of each generation. This is well illustrated 
in the following genealogical tree given by Rossi: 



m.- 

Thief. 



? 



R. S. 

M. 
Insane. 



Convicted of 
wounding. 



A 



Convicted of 
wounding 
and fraud. 

A drunkard. 



— M.- 
Thief. 



— M. 
Thief. 



L 


1 


1. 


Il 


1 
M. 


L 


k 


Pickpocket. 

Five times 

feigned 

madness. 


Com 

c 

fra 


icted 

>f 

ud. 


Thief. 


Receiver 

of stolen 

goods. 


Thief. 


Honest 

and 
Healthy 



M. 

Thief. 

Convicted 

of 
wounding. 

Of all the persons convicted of wilful murder in Eng- 
land and Wales between the years 1879 and 1888, 32 per 
cent, were found insane. 

It is needless to say that a member of a degenerate 
family should never marry and thus transmit the criminal 
tendency. 

HEREDITY IS SOMETIMES A FACTOR IN CONSUMPTION. 

Consumption is a contagious rather than an hereditary 
disease. It is caused by a minute germ which, on entering 
the system, produces destructive changes, chiefly in the 
lungs. The germ is present in the spittle of consumptives 
and may be transmitted by kissing or using the same spoon, 
fork or tumbler. It also is set free from sputum which has 
not been disinfected and may enter the lungs with the in- 
spired air. 

Those Liable to Consumption. — While consumption 
itself is not inherited, it often occurs in persons who from 
birth are characterized by lowered vital resistance. 

This condition of inability to resist disease may be 
transmitted. It is often found in those who have a family 



138 HEREDITY. CONSANGUINITY. 

history of consumption. It may also occur in those whose 
parents have lowered vital energy caused by other affec- 
tions, such as alcoholism, syphilis, cancer, diabetes, unfavor- 
able age for or too rapid procreation, or privation, exhaus- 
tion or depression affecting the mother during pregnancy. 

As a rule, however, the condition is acquired. It may 
result from depression, as grief, disappointment, fear, shame, 
anxiety, shock, religious gloom and terror. It is often 
caused by privation, including want of proper food, want 
of air, want of heat, want of cleanliness, want of shel- 
ter, want of clothing, want of light and want of enjoy- 
ment. Very frequently it comes from exhaustion, such as 
dissipation, over-eating and over-drinking, over-exercise, 
exhausting or unresting labor, physical or mental, pro- 
longed lactation, lactation continuing during pregnancy, 
too frequent and rapidly succeeding pregnancies, the effects 
of certain diseases (typhoid fever, measles, influenza, dia- 
betes), and from violent or consuming emotions, such as 
rage, jealousy, greed, inordinate ambition, and the like. 

Persons who have this condition of underdevelopment 
and lessened vital force may transmit it to their children. 
If they marry into a family with the same failing, this 
tendency in the offspring will be more marked. As a rule, 
however, by careful attention to the laws of hygiene and the 
methods of living described in this book, the tendency to 
consumption may be overcome. A person with such an 
hereditary taint, by proper living, may not only avoid hav- 
ing consumption herself, but may so eradicate this family 
failing that it will not appear in the children. 

THE MARRIAGE OF SYPHILITICA 

Syphilis is not an hereditary disease, strictly speaking, 
but it may be transmitted to the offspring from either 
parent. A person who has once had this disease should 



HEREDITY. CONSANGUINITY. 139 

not be married until a physician has declared the disease 
cured and has given his permission for the marriage. 

The period of danger may last from two or three years 
after the onset of the disease to ten or fifteen years after it, 
depending upon the faithfulness with which the treatment 
has been carried out. 

CONSANGUINEOUS MARRIAGES. 

The question of consanguineous marriages is usually 
settled by the law, in many States the marriage of first 
cousins being forbidden. There is no physiological reason, 
however, why such marriages should not take place. A 
committee appointed by the New York State Medical So- 
ciety to investigate the influence upon the offspring of con- 
sanguineous marriages stated in its report that if the family 
be free from degenerative taint, marriage among its mem- 
bers in no way diminishes the chances of healthy offspring. 
Other authorities have also agreed that there is no greater 
amount of disease or deformity among the offspring of 
parents related to each other by blood than among the chil- 
dren of parents not so related, provided the parents be 
equally free from tendency to disease or degeneration. 

Such marriages, however, are almost certain to trans- 
mit in an accentuated form any disease or defect already 
present in the family. Inasmuch as at the present time 
there can scarcely be found a perfect human family — almost 
every family having a taint or tendency to disease of 
some kind — and as all such imperfections are transmitted 
and rapidly deepened in the family by the intermarriage of 
its members, it is best that such unions in all cases be for- 
bidden. They should be discountenanced even in healthy 
families, for such union may wake up some pathological 
character which has been latent for one or two generations. 



CHAPTER XIV. 

THE BASIS OF HAPPINESS IN MARRIED 

LIFE. 

Cove is kept by art. The influence of the personal appearance. Care in the 
personal appearance. Dressing for the world rather than for the home. The 
invasion of the home by conventionalities. The husband neglected for the 
children. The avoidance of contention. The economic dependence of 
woman. Humiliation dwarfs a woman's character. The question of pocket 
money. Race Suicide. Healthy home life necessary. 

"Unjustly all our nymphs complain, 
Their empire holds so short a reign, 
Is after marriage lost so soon, 
It hardly holds the honeymoon : 
For if they keep not what they caught, 
It is entirely their own fault; 
They take possession of the crown, 
And then throw all their weapons down. 
Though by the politician's scheme, 
Who'er arrives at power supreme, 
Those arts by which at first they gain it, 
They still must practice to maintain it." — Swift. 

* LOVE IS KEPT BY ART. 



pjfTIEAN SWIFT says that the reason why so few mar- 
ybgj riages are happy is because young ladies spend their 
Ellis) time in making nets to catch men's hearts, not in 
making cages to keep them. The same thought was 
expressed by Ben Jonson when he remarked that "Love 
comes by chance, but is kept by art." According to Ben- 
jamin Franklin happiness in married life is preserved by 

140 




Copyright, 1904, by William H. Rau. 



MOTHER THE QUEEN OF THE HOUSE. 

After the children come to manhood and womanhood the mother and 
father find old age made happy by the presence of those able to grace the 
hearthstone and help bear the burdens of life. 



HAPPINESS IN MARRIED LIFE 141 

carefully avoiding litigious wranglings and capricious con- 
tentions, and by cultivating dispositions of reciprocal conde- 
scension and such a uniformity in tempers that the pleasures 
of one may be the pleasures of both. 

"An ambition," he says, "to please each other, and oblige 
by all the little turns of behavior, that so frequently will occur 
to a polite and well-disposed inclination, must have a won- 
derful good effect to support our affections, secure mutual 
esteem and friendship. Minds of any refined cast have an 
exquisite relish for these soothing and expressive marks of 
tenderness, and they can't fail of meeting with a most grateful 
reception. We should make it our mutual study to render 
ourselves agreeable and amiable by all the innocent arts 
of invention, and every laudable stratagem of conduct. . . . 
The little oversights and sallies of frailty, to which human 
nature is ever liable, and from which the most perfect charac- 
ters are not exempt, should be passed over and die unnoticed " 

The Obligations of Marriage. — A distinction is drawn 
by Felix Adler between the inducements that lead to marriage 
and the obligations ensuing, after the marriage is effected. 
The inducements to marriage, he says, are often of an 
ephemeral sort; beauty, for instance, or charm, or accomplish- 
ments. But there is no stipulation that the marriage shall 
last only so long as those last. The obligations of marriage 
are to perpetuate and enhance the spiritual life of the world, 
to keep burning the flame of mentality on earth; to subject 
oneself to the modifying influence of the other sex, and to 
throw all the profit of this influence into the life of the 
offspring; to confer perpetual benefits each on the other, 
especially benefits of the highest kind, by ministering each to 
the others moral growth. 

The Influence of the Personal Appearance. — It is 
remarkable what an influence personal appearance exerts on 
marital happiness. Too little attention to dress in the 



142 HAPPINESS IN MARRIED LIFE 

privacy of the home and too much in the conventionality 
of the outside world has frequently been the cause of dis- 
satisfaction. 

Care in the Personal Appearance. — Franklin advises 
people to be most careful and exact in their personal ap- 
pearance. "It is surprising/' he says, "but too common to 
see (amongst both sexes) many, who before marriage were 
very assiduous in the adorning and neatness of their per- 
sons, that afterward grow negligent and highly culpable by 
the reverse, which attention and remissness, I verily be- 
lieve, is often one of the first and most effectual methods to 
cool the affection, and estrange the hearts of many a couple. 
And herein, according to the most impartial observations I 
have made, the ladies are most blamable." 

Dressing for the World Rather Than for the Home. — 
Sheldon asserts that "the wife dresses too much with an 
eye to the outside world, rather than with a thought as to 
what will please her husband's eye. She may wonder why 
he does not take more interest in her toilet, and may not be 
aware of the fact that her husband's taste may not be that 
of her conventional women friends. What might charm 
him would perhaps be simplicity, while the world outside 
asks for display. Why is it that a wife thinks less about the 
charm of her dress at her private dinner-table to the one pair 
of eyes opposite to her, than she does about the dress she 
is to wear if there are to be guests at the table? Why is it 
that the world's eye in this regard may become of even 
greater importance than the eye of the husband?" 

The Invasion of the Home by Conventionalities. — The 
domination of the sanctity of our homes by the outside world 
is an appalling circumstance which menaces the institution of 
the family, according to this same writer. "For just this rea- 
son," he says, "a kind of estrangement may set in between 
husband and wife, making the tie between them prosaic and 



HAPPINESS IN MARRIED LIFE 143 

common-place. Each is a little disappointed in the other, 
partly for the reason that they have thought too little about 
pleasing each other in the home and about having the home 
and home-life just for the sake of themselves. 

"It is my conviction that the woman, who, if she fol- 
lowed her own spontaneous inclinations, would be the home- 
maker and care supremely to have a perfect home for its 
own sake, has for a time been carried out of her own most 
instinctive disposition, through a transient submission to 
conventionality. 

"If, as is true to-day over many parts of the world, the 
wife is little by little growing disappointed in the husband, 
as being prosaic and not caring for the family or for herself 
in the way she had hoped, I believe one of the causes for it 
lies right here. The man, the husband, does not feel at ease 
or at home in many parts of his own house. He does not feel 
at home even with his own wife. He is vaguely conscious 
that the woman of his choice belongs not only to him, but to 
a great show-world outside. Down in his heart there is a 
lurking disappointment. The home does not seem to come 
overwhelmingly first in the thought of his wife." 

THE HUSBAND NEGLECTED FOR THE CHILDREN. 

Sheldon also asserts that nowadays the husband is often 
neglected by the wife for the sake of the children, where he 
is not neglected for the sake of the conventional outside 
world, although he believes that every mother will be up in 
arms against him at this point. The average mother will 
ask, "Can a woman do too much for her children ?" He an- 
swers: "Yes, especially where the service for the children 
may not apply to their actual needs, but be rendered in order 
to keep up to a conventional standard. In this way, too, the 
man is led to feel as if he has a house and home, not for him- 
self, but for his children. The tendency here has gone to an 



144 HAPPINESS IN MARRIED LIFE 

extreme. In the old days it was otherwise. Wife and chil- 
dren were all neglected for the sake of the head of the fam- 
ily. He was the sovereign and it was a brutal sovereignty. 

"To-day the situation is precisely the contrary. The 
needs of the child come first. The mother asks it and the 
father and husband grants it from a sense of duty, if for no 
other reason. But in many a man, at the present time, there 
is developing on this score a spirit of rebellion. The wife 
may not be conscious of it because of her devotion for her 
children. Later on she becomes aware that something has 
happened in the lack of interest for herself or the home on 
the part of the husband. The cause for this, however, may 
never dawn upon her, because the change took place in those 
years when she was completely rapt up in her little ones. ,, 

THE AVOIDANCE OF CONTENTION. 

The conditions described by Sheldon are not the only 
ones that are responsible for unhappiness in married life. 
Misunderstandings between husband and wife are often 
caused by disputes and contentions over little things. 
Neither listens to Pope's advice: 

"At every trifle scorn to take offense, 
It always shows great pride or little sense." 

Unhappiness may often be avoided and the mutual love 
and respect retained until the end by observing the warning 

of Swift : 

"Let prudence with good nature strive, 
To keep the flame of love alive, 
Then, come old age whene'er it will, 
Your friendship shall continue still: 
Thus a mutual, gentle fire, 
Shall never but with life expire." 

"A little observation and reflection on the common 
scenes of matrimony," wrote Franklin, "may supply us with 



HAPPINESS IN MAREIED LIFE 146 

many instances to show how much these trivial jarrings 
spoil the harmony, and interrupt the felicities of it. 

"What fermentations and heats often arise from break- 
ing of china, disordering a room, dinner not being ready at 
a precise hour, and a thousand other such impertinent 
bagatelles. 

"But trifling as these things may be in themselves, it is 
too notorious they often occasion such feuds and feverish 
animosities amongst married people, as frequently give a 
bitter tincture to and discompose many hours of their lives; 
and are sometimes of so bad a consequence as to inflame 
their minds with such spleen and distaste that irreparable 
breaches are thereby opened." 

THE ECONOMIC DEPENDENCE OF WOMAN. 

The emancipation of woman from her original posi- 
tion as a slave in the household has been most erratic, ac- 
cording to Sheldon. Whereas there has come a freedom 
in the disposal of her hand before marriage, and the aboli- 
tion of slavery after marriage, there is still to a large extent 
a dependence on the economic side which does practically 
hold woman to a position of serfdom. "It is," he says, "per- 
haps the most painful experience through which the average 
woman must undergo, who has no income of her own, when, 
after the first year of marriage and the two have settled 
down to an equilibrium of existence, she finds herself com- 
pelled to resort to a multitude of petty artifices in order to 
secure the small sums essential for her personal needs or 
requirements. This has stifled the budding soul of more 
women than almost any other experience. And the man 
may discover it only when it is too late. It may perplex him 
why his marriage-life has grown prosaic; why the charm 
has been vanishing out of his home life. 

Humiliation Dwarfs a Woman's Character. — "There is 

IO 



148 HAPPINESS IN MARRIED LIFE 

a certain degree of dependence which may be ennobling on 
the character. But if it is carried beyond a given point, it 
works in precisely the contrary way; the nature is stunted 
or dwarfed. And this dwarfing process is going on in 
thousands of families all over our land, because the wife is 
subject to so much of this exacting humiliation. The man 
himself may suffer indirectly even more from this than the 
woman. He has lost something out of his married life 
which cannot be replaced. Instead of the wife and com- 
rade, little by little he discovers that he has only a house- 
keeper or a mother for his children. And the responsibility 
for it may lie altogether at his own door. He has failed to 
treat his wife as a comrade; and they are both victims of his 
mistake." 

The Question of Pocket Money.- — A writer many years 
ago in a woman's magazine held that on account of the treat- 
ment of wives by their husbands as regards pocket money, 
many a nice, bright girl, who has become self-supporting 
and knows the comfort of freedom in the matter of spending 
money, hesitates and needs a very strong attraction before 
she is drawn into marrying anyone, thus shutting off from 
the race the very force and talent which it needs in mothers. 

"If a wife has not sufficient wisdom to know when to 
spend money in accordance with her own and her husband's 
means," writes this contributor, "she has not sufficient wis- 
dom to keep a house or to bring up her children, and she 
should not, in fact, be allowed to marry. Of a man having 
a wife of discretion, yet, still unwilling to let her spend as 
she sees fit, it may be said that he has no business to marry 
and establish a household unless he can afford a house- 
keeper and a housekeeper's wages, and pay those wages to 
the wife every Saturday night, or at such other time as she 
chooses. The woman who combines in herself, as the 
majority of wives do, the office of housekeeper, cook, cham- 



HAPPINESS IN MARRIED LIFE 147 

ber-maid, governess, nurse, and seamstress, ought to have 
something more than her clothes and the title of mistress in 
recompense. When she is discharged from any of these 
offices, and has a servant of her own whose wages are regu- 
larly paid, it is still something of a humiliation to her to see 
that person with more money than she herself, able to please 
her whim in purchases, always with a dollar or two in her 
pocket ready for the emergency of charity, or gift, or ex- 
penditure, while she herself in that rank and condition where 
more is expected of her is unable to take a ticket for this 
affair, or give a coin to that beggar, or send to the shop for 
a purchase until she has asked for the money." 

PRESIDENT ROOSEVELT ON RACE SUICIDE. 

One of the most important problems of the married life 
confronting the American people of to-day is that of race sui- 
cide. In an address before the National Congress of Mothers 
at their meeting at Washington, in March, 1905, President 
Roosevelt said: "The Nation is in a bad way if there is no 
real home, if the family is not the right kind, if the man is 
not a good husband and father, if he is brutal or cowardly 
or selfish, if the woman has lost her sense of duty, if she is 
sunk in vapid self-indulgence or has let her nature be twisted 
so that she prefers a sterile pseudo-intellectuality to that 
great and beautiful development of character which comes 
only to those whose lives know the fullness of duty done, of 
effort made and self-sacrifice undergone.. . . 

Healthy Home Life Necessary. — "No piled-up wealth, 
no splendor of material growth, no brilliance of artistic de- 
velopment, will permanently avail any people unless its 
home life is healthy, unless the average man possesses hon- 
est} 7 , courage, common sense, and decency, unless he works 
hard and is willing at need to fight hard ; and unless the 
average woman is a good wife, a good mother, able and will- 



148 HAPPINESS IN MAREIED LIFE 

ing to perform the first and greatest duty of womanhood, 
able and willing to bear, and to bring up as they should be 
brought up, healthy children, sound in body, mind and 
character, and numerous enough so that the race shall in- 
crease and not decrease 

Woman's Task, Motherhood. — "Just as tne happiest 
and most honorable and most useful task that can be set any 
man is to earn enough for the support of his wife and family, 
for the bringing up and starting in life of his children, so the 
most important, the most honorable and desirable task 
which can be set any woman is to be a good and wise mother 
in a home marked by self-respect and mutual forbearance, 
by willingness to perform duty, and by refusal to sink into 
self-indulgence or avoid that which entails effort and self- 
sacrifice.. . . 

"No mother has an easy time, and most mothers have 
very hard times, and yet what true mother would barter her 
experience of joy and sorrow in exchange for a life of cold 
selfishness, which insists upon perpetual amusement and the 
avoidance of care, and which often finds its fit dwelling place 
in some flat designed to furnish with the least possible ex- 
penditure of effort the maximum of comfort and of luxury, 
but in which there is literally no place for children? 

Respect Due a Good Wife and Mother. — "The woman 
who is a good wife, a good mother, is entitled to our respect 
as is no one else; but she is entitled to it only because, and so 
long as, she is worthy of it. Effort and self-sacrifice are the 
law of worthy life for the man as for the woman, though 
neither the effort nor the self-sacrifice may be the same for 
the one as for the other. . . . 

The Woman who Merits Contempt. — "There are many 
good people who are denied the supreme blessing of chil- 
dren, and for these we have the respect and sympathy al- 
ways due to those who, from no fault of their own, are denied 




THE MOTHER'S MORNING DELIGHT. 

77 is the mother's pleasure in the morning to give the 
bath. The child, while it is taken from its crib by the sunny u . 
and made ready for the bath, plays in its mother's ai 



HAPPINESS IN MARRIED LIFE 149 

any of the other great blessings of life. But the man or 
woman who deliberately foregoes these blessings, whether 
from viciousness, coldness, shallow-heartedness, self-indul- 
gence or mere failure to appreciate aright the difference 
between the all-important and the unimportant — why, such 
a creature merits contempt as hearty as any visited upon the 
soldier who runs away in battle, or upon the man who re- 
fuses to work for the support of those dependent upon him, 
and who, though able-bodied, is yet content to eat in idle- 
ness the bread which others provide. 

"The existence of women of this type forms one of 
the most unpleasant and unwholesome features of modern 
life.... 

The Mother "Blessed."— "The man is but a poor 
creature whose effort is not rather for the betterment of his 
wife and children than for himself; and as for the mother, 
her very name stands for loving unselfishness and self-abne- 
gation, and, in any society fit to exist, is fraught with 
associations which render it holy. 

"The woman's task is not easy — no task worth doing 
is easy — but in doing it, and when she has done it, there shall 
come to her the highest and holiest joy known to mankind ; 
and having done it, she shall have the reward prophesied in 
Scripture; for her husband and her children, yes, and all 
people who realize that her work lies at the foundation of 
all national happiness and greatness, shall rise up and call 
her blessed." 



CHAPTER XV. 

PREGNANCY : THE DEVELOPMENT OF 
THE CHILD. 

An explanation of Nature's mysteries. Reproduction: In plants; in the lower 
animals; in man. Conception. The development and nourishment of the 
embryo or unborn child. The placenta and umbilical cord. Changes in 
the mother during pregnancy. Lightening. 

"Come forth into the light of things, 
Let Nature be your teacher.' , 

— Wordsworth. 

The physiology of so important an event as pregnancy 
should be understood by every woman. Emphasis has 
already been laid on the necessity of a mother explaining 
Nature's mysteries to her daughter in an intelligent and 
tactful manner. Matters of this kind, however, should be 
regarded in a broad light, the whole world being included 
in the view. The description given on the following pages, 
it is hoped, will not only make the matter clear to the 
mother, but will also suggest to her a, way to present this 
delicate subject to her daughter. 

REPRODUCTION THROUGHOUT NATURE. 

It has been shown earlier in this book how Nature has 
provided all living matter with the power of reproduction, 
or of forming new members of the family. 

Everything Composed of Cells.— When seen under the 
microscope, all plants and all animals are found to be com- 
posed of minute bodies, called cells. The shape and kind 

150 



PREGNANCY 



151 




Lung Cells. (Magnified.) 



of these cells vary in different structures. The roots of a 
tree are made of one kind of cell, the leaves of another, 

the bark of a third, the fruit of still 
a fourth, and so on. In the same 
way skin, muscle, bone, hair and 
nails are each composed of a dif- 
ferent kind of cell. 

All new individuals begin with 
one cell, which divides and subdi- 
vides until it forms many cells, each 
of which grows and divides again. 
The ovule in a seed divides, some 
of the cells forming roots, others 
becoming stem and leaves. 

Various Methods of Reproduction. 
*— -The original cell that forms the 
new body is produced in va- 
rious ways. In the yeast 
plant and in the hydra the 
new cells appear as buds on 
the parent cell. Sometimes, 
as in seaweed and in the 
green slime or algae seen on 
stagnant pools, the parent 
cell divides into two daughter 
cells. In all higher forms of 
life, however, a union of two 

dissimilar cells is necessary to form the first cell of the 
young organism. Most plants and animals develop certain 
cells, w T hose sole object is to perpetuate the species. These 
cells usually are of two kinds. One kind becomes converted 
into the young cell as soon as it comes in contact with the 
other. The first is called the female cell, the second the 
male cell. 




Muscle Cells. (Magnified.) 



152 PREGNANCY 

In flowers the pistil is the female element, its stigma 
and style forming a tube leading down to a sort of nest, 
called the ovary, in which lies the ovule or female repro- 
ductive cell. The pollen on the stamens represents the 
male reproductive cell. When blown by the wind, or car- 
ried on the antennae or sucking tubes of insects down the style 
of the pistil it fertilizes the ovule which lies at the bottom. 
As soon as the ovule comes in contact with the pollen it 
begins to divide and finally becomes a seed, capable of pro- 
ducing another plant. 

In animals, as a rule, a union of the male and female 
elements is necessary. As the impregnated cell divides, a 
living creature begins to be formed, which, at first, is not 
always like the parent. From the egg laid by the butterfly 
crawls the caterpillar, which later builds its cocoon and 
emerges a fully developed butterfly. The tadpole is hatched 
from the egg of a frog and, after continuing to grow as a 
water animal, it one day sheds its skin and becomes a frog. 

REPRODUCTION IN HUMAN BEINGS. 

Every month a woman discharges from the ovary a 
mature ovum, which enters the funnel-shaped end of the 
Fallopian tube and travels down toward the uterus. If 
at this time any male cells, called spermatazoa, happen to 
be in the tube, having worked their way up through the 
uterus from the vagina, one of them may penetrate the 
ovum or female reproductive cell. 

The moment the two cells unite, conception has oc- 
curred, and the resultant cell formed by this union is the 
beginning of the future child. This cell divides into two 
cells and then into four, eight, sixteen, and so on, as is shown 
in the figure on the following page. 

As the cell or egg divides it passes into the cavity of 
the uterus, where it lodges in one of the folds of the thick- 



PREGNANCY 



153 



ened lining membrane. Here for nine months it develops, 
first into an embryo with gills and a tail, then into a fetus 
or crudely formed child, and finally into a normal infant. 
The shell or outer part of the egg is formed by the mem- 
branes. The developing child lies surrounded by the waters 
or amniotic fluid. As the cells continue to divide, they be- 
come specialized, some going to form the skin, others to 
make muscle, bone, and so forth. 



ZONA 
PELLUCIDA 



POLAR 
GLOBULES. 




The Developing Ovum. 

The dividing cells which are to form the living child are here shown. 
The numbers indicate the different stages in the development of the ovum. 



Nourishment of the Child within the Womb. — The 
fetus is nourished by the mother's blood, which enters its 
body at the umbilicus or navel. Three long blood-vessels 
extend from a thickened spot on the uterine wall, called the 
placenta (which forms part of the afterbirth), to the child's 
navel, at which point they enter the body. These vessels 
are surrounded by a jelly-like substance, which protects 
them from injury and with which they form the umbilical 
cord. 



154 



PREGNANCY 



Shortly after the child is born the umbilical cord is tied 
off and severed, the infant's end then drying up and later 
falling off. 

CHANGES IN THE MOTHER DURING PREGNANCY. 

Changes occur during pregnancy in the mother as well 
as in the child. The womb or uterus becomes enlarged as 
the fetus increases in size; it rises from the pelvis into the 
abdomen at the fourth month, is at the level of the navel at 
the sixth month, and at the ninth month reaches its highest 
point, a little below the pit of the stomach. The accom- 
panying illustration shows the comparative size and posi- 
tion of the uterus during the different periods. 

During the ninth month the 
child's head leaves the abdomen 
and enters the pelvis, the top of 
the womb dropping to where it 
was at the eighth month. This 
occurrence is familiarly spoken 
of as "lightening" or dropping. 

The walls of the abdomen be- 
come stretched, with the forma- 
tion in the skin of white, bluish 
or reddish streaks. They also be- 
come loaded w T ith fat, giving a 
fuller appearance to the figure. 
Pressure of the uterus on the 
Section of the Abdomen in a bladder and rectum interferes 

Pregnant Woman. w j th the j r f unct i onS) causing COn- 

Showing the size of the womb ... ,. i £ . • .• 

at the different periods of preg- Ration and frequent urination. 
nancy. The figures indicate the Pressure on the veins may give 

month of pregnancy. fise tQ nemorr } w id S } or piles, and 

to varicose veins of the legs and vulva or external parts. 
The nerves of the uterus are so upset by the stretching that 




PREGNANCY 155 

they carry the irritation to the stomach, thus producing 
nausea and vomiting. 

The nervous system itself also undergoes a change, 
which shows itself in alterations in disposition, in perver- 
sions of taste, such as a longing for pickles or some other 
odd article of food, in a tendency to become melancholic 




The Child in the Womb. 

and in the occurrence, at times, of severe neuralgia, espe- 
cially of the face and teeth. 

For some unknown reason the teeth during pregnancy 
exhibit a tendency to decay. It is a common saying that a 
woman loses a tooth for each child she bears. 



CHAPTER XVI. 



THE SYMPTOMS OF PREGNANCY. 

Determination of the existence of pregnancy. The commonest symptoms of 
pregnancy: The cessation of menstruation; Morning sickness; Appearance 
of the face; Changes in the breasts; Changes in the size, shape and appear- 
ance of the abdomen. Quickening: Alterations in the nervous system. 
Change in color of the mucous membrane. Hearing the fetal heart sounds. 
The physician's examination. 



"Coming events cast their shadow before." — Campbell. 
DETERMINATION OF THE EXISTENCE OF PREGNANCY. 



S a rule, it is not a difficult matter to determine 
whether a woman is pregnant, although cases have 
occurred in which mistakes were made. Physicians 
have operated on a supposed abdominal tumor only 
to find a pregnant uterus. 

There are certain symptoms, however, which are us- 
ually present in a woman who is with child. But they may 
occur in conditions other than pregnancy, and they may 
be absent, though the woman be "in a family way." The 
physician is the only person who is competent to decide. 
The Commonest Symptoms of Pregnancy. — The most 
common symptoms of pregnancy experienced by the mother 
are (i) cessation of menstruation, (2) "morning sickness," 
(3) changes in the size, shape and appearance of the ab- 
domen, (4) changes in the breasts, and (5) quickening. 

THE CESSATION OF MENSTRUATION. 

As soon as a woman becomes pregnant, menstruation 
usually ceases. But its absence may depend upon other 

156 





■^ i 



THE SYMPTOMS OF PREGNANCY 157 

causes, as in the condition known as amenorrhea, which is 
described in Chapter XXXIV on "Disorders of Menstrua- 
tion." In some few cases there is a slight bloody discharge 
during the first three months of pregnancy. It will thus be 
seen that the sign is not an invariable one. 

THE MORNING SICKNESS. 

At the sixth or seventh week of pregnancy nausea and 
vomiting appear, usually lasting to the third month, being 
worse when the woman first arises from bed in the morn- 
ing, whence it derives the name "morning sickness. " It is 
not always present and may exist in many other conditions. 

THE APPEARANCE OF THE FACE. 

After conception has occurred, dark, irregular splotches, 
resembling freckles, called chloasmata or liver marks, may 
appear in the brow and cheeks, sometimes running so closely 
together as to form .the so-called "mask of pregnancy." 
Dark rings also often form under the eyes. These, too, 
occur in other conditions and cannot be regarded as 
diagnostic. 

CHANGES IN THE BREASTS. 

During pregnancy the breasts become enlarged and 
distended. The veins can be plainly seen. As the disten- 
sion continues, white Hues or striae, resembling cracks, ap- 
pear in the skin. 

Appearance of the Nipples. — The nipples themselves 
also become more prominent. The colored areola sur- 
rounding them becomes darker in color and broader in ex- 
tent. Little glands in this areola often become enlarged 
to the size of buckshot and project conspicuously. As 
pregnancy advances, a drop or two of a cloudy liquid, called 
colostrum, can be squeezed or milked out of the breast. 
The woman usually experiences a tingling sensation in the 



158 THE SYMPTOMS OF PREGNANCY 

breasts, owing to their congestion, and later a feeling of 
fullness when the colostrum begins to appear. 

All of these changes may occur without the existence 
of pregnancy; some, and rarely all, may be absent, even 
though that condition be present. 

CHANGES IN THE ABDOMEN. 

Increase in Size. — There is a progressive enlargement 
of the abdomen as the womb increases in size. Enlargement 
of the abdomen, however, occurs in many other conditions, 
and, on the other hand, it has existed without attracting 
the woman's notice. 

Alteration in Shape. — After the ninth month a change 
takes place in the shape of the abdomen as the child's head 
sinks into the pelvis and its body falls a little forward. 
This phenomenon is known as "lightening" or "dropping." 
With it there is a lowering of the waist line; the upper part 
of abdomen becomes flatter and the navel more prominent. 

Change in Appearance. — The umbilicus or navel be- 
comes gradually pushed out or everted. At the sixth month 
it is on a level with the surface of the abdomen, and later 
begins to pout. It is surrounded by a black ring. From 
this ring a black line extends along the middle of the ab- 
domen upward to near the pit of the stomach and down- 
ward to the pelvis. The line is given the name of linea 
nigra, which means black line. 

Owing to the stretching of the abdomen, white lines 
or striae, looking like cracks, appear in the skin, especially 
in the region of the flanks and the hips and along the outer 
side of the thighs. 

THE OCCURRENCE OF QUICKENING. 
A living fetus, or unborn child, moves about within 
the womb, but not until about midway between the fourth 
and fifth months are the movements powerful enough to 



THE SYMPTOMS OF PREGNANCY 159 

be felt by the mother. The sensation the mother ex- 
periences when the fetus moves is called "quickening." It 
has been felt as early as the third month, but may not be 
noticed at all until the last month. During the advanced 
stages of pregnancy fetal movements can usually be felt 
by a person laying a cold hand suddenly upon the woman's 
abdomen. There are two kinds of sensations conveyed to 
the hand: a heaving and a sensation compared to that' of 
a finger-tap under a blanket. 

Necessarily, movements are never felt when the fetus 
is dead. They may be undetected even when it is living. 
There are many things, moreover, which may simulate these 
movements and thus lead one astray. 

ALTERATIONS IN THE NERVOUS SYSTEM. 

A pregnant woman usually exhibits some disorder of 
the nervous system, becoming more sensitive .and irritable. 
Her disposition may change from placidity to vivacity, or 
from amiability to sullenness or moroseness. Sometimes 
the moral nature is affected, with impairment of the ability 
to distinguish between right and wrong. The appetite may 
become very fanciful and the most unusual articles of diet 
may be craved. Often a woman experiences a sense of 
dizziness or a feeling as if she were going to faint, or she 
may even lose consciousness. Neuralgia, especially of the 
face and teeth, is not uncommon. 

Such symptoms, of course, cannot solely be regarded 
as indicative of pregnancy. 

CHANGE IN COLOR OF THE MUCOUS MEMBRANE. 

During the second half of the period of gestation, and 
sometimes as early as the second month, the mucous mem- 
brane of the vagina assumes a bluish or purplish hue, which 
has been compared to the color of the lees of wine. About 



160 THE SYMPTOMS OF PREGNANCY 

the same time the color of the mucous membrane about 
the entrance changes from a pink to a bright scarlet. 

These are not infallible signs, however, as they may 
be produced by other conditions and may even be absent 
throughout the whole of pregnancy. 

HEARING THE FETAL HEART SOUNDS. 

After the fifth month, if the fetus is alive, its heart 
sounds can usually be heard by applying the ear to the 
woman's abdomen. The place where they commonly are 
heard best is a spot about an inch below the navel, to the 
left (sometimes to the right) of the median line. The heart 
of the unborn child beats at the rate of 120 to 160 a minute. 
Two sounds are heard with each beat. The sound has been 
compared to the ticking of a watch under the pillow. It 
must not be mistaken for the woman's heart beat, which 
is a single sound, keeping time with her pulse. Many con- 
ditions may prevent the fetal heart sounds being heard. 

THE PHYSICIAN'S EXAMINATION. 

There are some signs of pregnancy that are found 
on an internal examination, which, of course, only the phy- 
sician can make. It is impossible, however, for any one 
to make a positive diagnosis of pregnancy before the sixth 
week, and sometimes not until the fourth month. 

THE DISORDERS OF PREGNANCY. 

The disorders and diseases that occur during pregnancy 
will be considered in a later chapter. 



CHAPTER XVII. 

THE LIFE OF A WOMAN DURING 
PREGNANCY. 



Diet. Dress: hygienic or maternity waists and corsets; the abdominal bandage. 
Exercises to strengthen the muscles and preserve the figure. Bathing 
during pregnancy. Work, exercise and rest. Maternal Impressions. 
Keeping the mind in pleasant channels. How to render labor easy. Care 
of the breasts during pregnancy. Preparation of the nipples. Care of 
excretions and discharges: the urine; the bowels; leucorrhea. Marital 
relations during pregnancy. 



"For life is not to live, but to be well." — Martial. 

nTTHANY women make no change in their lives with the 
feiyJ advent of pregnancy, but continue as though their 
I gggg J condition is attendant with no danger. Such a view 
is erroneous; the border line between health and dis- 
ease may easily be passed during pregnancy unless the 
woman is careful about her mode of life and reports to her 
physician any unusual symptoms that may develop. The 
health of the child as well as of the mother depends in great 
measure upon the hygiene of this period. 



THE DIET DURING PREGNANCY. 

During pregnancy the diet should be simple and in ac- 
cordance with the directions in Chapter VI. Meat should be 
eaten but once a day and then only in small quantities. 
Cereals, fresh vegetables and fruits should form the princi- 
pal articles of food. Milk should be taken in large quantities 
— plain, diluted with plain or effervescing water or with 
lime-water, cooked with vegetables, or made into puddings, 

11 161 



162 



LIFE DURING PREGNANCY 



etc. Rich and indigestible food must be avoided. Water 
should be drunk freely, at least one or two quarts during 
the day. Alcoholic drinks are prohibited. The woman 
should also take very little tea or coffee. 

Morning sickness may sometimes be prevented if be- 
fore getting up, while lying flat on her back in bed, the 
woman takes a hot drink of milk, broth, cocoa, chocolate, 
tea, or coffee, with or without toast, and remains in bed for 
half an hour afterwards before attempting to get up. 

THE DRESS OF THE PREGNANT WOMAN. 

More so than at any other time the rules laid down in 
Chapter V on "Clothing" should be strictly observed during 





Waist with buttons for sup- 
porting the skirts. 



Skirt Supporter or 
suspenders. 




Abdominal 
bandage. 



pregnancy. Silk or wool must be worn next to the skin, the 
shirt having a high neck and long sleeves. The use of gar- 
ters should be discountenanced. All compression about the 
waist must be avoided. The ordinary corset therefore must 
be discarded but in its place an hygienic waist or corset made 



LIFE DURING PREGNANCY 163 

especially for pregnant women may be worn. Of these there 
are many upon the market, including the Ferris maternity 
waist, the Jenness-Miller waist and the Wade hygienic cor- 
set. 

Heavy skirts and tight bands must be avoided. The 
skirts should be suspended from the shoulders by means of 
suspenders or a waist. 

When the abdominal walls are weak the muscles be- 
come so overstretched that after labor they may fail to prop- 
erly hold up the various organs, with resultant protuberant 
abdomen, filling of the stomach and intestines with gas, 
movability of the kidneys and dropping of the stomach and 
other viscera. These consequences are prevented and the 
abdominal muscles strengthened by the practicing before 
pregnancy of the exercises described in Chapter IV and by 
participation in various sports such as those mentioned in 
Chapter VII. The maternity waists and corsets just de- 
scribed will furnish some support to the abdomen. Great re- 
lief may be afforded by wearing a broad, properly adjusted 
abdominal bandage made of flannel, muslin or ribbed wool, 
or of silk and elastic. 

High-heeled shoes are very injurious, as they throw for- 
ward the trunk, which already tends to fall in that direction, 
and cause the woman to bend back her head and shoulders 
to keep her balance, thus straining the muscles along the 
spine. 

BATHING DURING PREGNANCY. 

It is especially important during pregnancy to promote 
excretion by the skin. For this purpose frequent warm tub 
baths with an abundant use of soap are required They are 
taken best at night just before retiring. For its general 
hygienic effect a cool sponge bath in the morning, such as 
described in Chapter II, is beneficial. Very hot and very 



164 LIFE BUSING PBEGNANCY 

cold baths, foot-baths, and surf-bathing are dangerous dur- 
ing pregnancy. 

WORK, EXERCISE AND REST DURING PREGNANCY. 

Work.— A pregnant woman should reduce her work to 
below what she is accustomed to, and never allow her- 
self to become fatigued. She must avoid jarring and strain- 
ing. She cannot work on the sewing-machine, move heavy 
furniture, lift a heavy weight, reach to a shelf, or do violent 
sweeping. 

Exercise.— Moderate daily exercise should be taken, at 
least during the early months. A woman may walk in the 
open air and sunlight or she may be driven in an easy car- 
riage over smooth roads, but she must not handle the reins 
herself. General massage may be given, which, however, 
must not include the abdomen. Horseback-riding, bicycling, 
golf, tennis, dancing, swimming, and all similar forms of 
violent exercise are to be avoided. The woman should not 
take a sea-voyage while in this delicate condition, nor should 
she travel much. 

Rest and Sleep.— The pregnant woman requires plenty 
of sleep. She should undress after the mid-day meal and lie 
down for an hour or so. 

MATERNAL IMPRESSIONS. 

In every bushel of chaff there can usually be found a 
grain of wheat. Similarly, despite the doubts cast by many 
physicians, there is an element of truth in the popular belief 
that strong impressions made on the mother during preg- 
nancy leave their imprint on the child. Sudden emotions 
of grief, fear and anger often do have an influence on the 
developing fetus. 

The pregnant woman, therefore, must be protected from 
disagreeable or heart-rending sights and associations, bad 
news, fright, and the like. She should lead a placid, quiet life 



LIFE DURING PREGNANCY 165 

amid cheerful surroundings and with pleasant diversions, 
reading good books, looking at beautiful pictures, and listen- 
ing to delightful music. She must not worry over her ap- 
proaching confinement or study all about the various compli- 
cations that occasionally are met with. Nor should she 
listen to gossiping neighbors or a thoughtless nurse recount- 
ing the difficulties of that process. Her mind should rest at 
ease with the knowledge that labor as a rule is a perfectly 
natural and normal process through which hundreds of 
women pass successfully every day, and that complications 
and accidents are of very rare occurrence. 

How to Render Labor Easy. — A woman may also de- 
rive comfort from the thought that if she live according to 
the directions given in this book, especially those in regard 
to clothing and exercise, she will be more apt to have an easy 
and uncomplicated labor, followed by a normal con- 
valescence. 

If the woman become melancholy or show any signs, 
however slight, of a deranged mind, the physician must be 
informed of the fact. 

More than at any other period of her life the wife during 
pregnancy requires the most thoughtful consideration of her 
husband. 

CARE OF THE BREASTS DURING PREGNANCY. 

The clothing should not be allowed to press upon the 
breasts. If the latter cause distress on account of their in- 
creasing size and weight, they should be supported accord- 
ing to one of the methods described in Chapter XXII on 
the management of the woman after labor. They should 
be washed daily with soap and warm water, any scales upon 
the nipples being removed. 

Preparation of the Nipples. — When the nipples are flat 
or retracted they must be drawn out during the latter 



166 LIFE DURING PBSGNANCY 

months of pregnancy, so that they will develop into a shape 
that the baby can grasp. This may be done by gently pulling 
them out from the breast with the thumb and index finger 
every night and morning, or by the use of the breast pump, 
or by covering them with a nipple protector or a nipple 
shield. 

The nipples will be rendered less sensitive and less liable 
to fissures if, during the last month of pregnancy, they are 
washed every morning with cold water and then anointed 
with a mixture containing equal parts of water and glycerole 
of tannin, applied with a piece of absorbent cotton. 

CARE OF EXCRETIONS AND DISCHARGES. 

The Urine. — The urine in its relation to pregnancy is 
thoroughly discussed in Chapter XIX. 

The Bowels. — The various methods of relieving consti- 
pation mentioned in Chapter XXXIII should be employed 
when that condition occurs during pregnancy. 

Leucorrhea. — A white, mucous discharge sometimes oc- 
curs from the vagina during pregnancy, and is treated ac- 
cording to the directions given in Chapter XXXIII. 

MARITAL RELATIONS DURING PREGNANCY. 

The marital relations need not necessarily be suspended 
throughout pregnancy, except during the early and late 
months, when they must cease on account of the liability 
to abortion at these times. Moderation, however, must 
always be strictly observed. Continence sometimes is rec- 
ommended, and is imperative if the woman have a tendency 
to abort. During the days corresponding with the usual 
menstrual period intercourse must always be avoided. 



CHAPTER XVIII. 

THE MENOPAUSE-"CHANGE OF LIFE. 



>t 




Age at which "change of life" occurs. Method of oncoming. Symptoms of the 
menopause: Headache, flushes of heat, derangement of the digestive and 
nervous systems. A mistake to attribute all symptoms at middle-life to 
the menopause. The physiology of the menopause. Importance of famil- 
iarity with the normal phenomena. The recognition of danger signals. 
Hygiene of the menopause. 

"Old age comes on apace to ravage all the clime." 

— Beattie. 

HE period during which a woman experiences the 
monthly sickness lasts on the average from thirty 
to thirty-two years. The final cessation of men- 
struation is spoken of as the menopause, climac- 
teric, or "change of life/' 

AGE AT WHICH THE MENOPAUSE OCCURS. 

In this country the menopause occurs, as a rule, be- 
tween the ages of forty and fifty, usually about the forty- 
sixth year. The age depends upon various conditions. 
When menstruation begins early it usually ends late, and 
when it begins late, ends early. The menopause may ap- 
pear prematurely in very fat women, in those suffering 
from consumption, Bright's disease, and diabetes, and in 
women who have borne a large number of children in rapid 
succession and have suckled them. It may be retarded in 
the presence of disease of the womb, tubes or ovaries, espe- 
cially when there is a fibroid tumor of the uterus. "Change 
of life" appears later in the northern part of Europe than 
in the southern, in England than in America, in country 

167 



168 THE MENOPAUSE 

women than in city women, and among the idle and well- 
to-do than among the laboring classes. 

METHOD OF ONCOMING. 

The menopause occurs in a variety of ways. In the 
majority of cases the amount of blood passed at each 
monthly period becomes gradually diminished until it 
ceases altogether. In other instances the menstrual flow 
stops abruptly and permanently. Sometimes one or more 
periods are skipped, after which the flow again occurs, per- 
haps with a lessened amount, followed by more irregularity 
and then by the final cessation. 

SYMPTOMS OF THE MENOPAUSE. 

If the woman's general health is good and if there is 
no disease of any kind, the menopause may be ushered in 
with no more symptoms than those already noted. No 
marked general disturbance is present in such a case. 
Many women, however, suffer from very annoying con- 
ditions for one or two years. Headache is a common symp- 
tom. "Flushes of heat" may occur frequently throughout 
the day, sometimes as often as several times within an 
hour. They consist of a feeling of heat over the whole 
body or over a part, followed by sweating and a cold, chilly 
sensation. The digestive apparatus often gets out of order. 
Large accumulations of fat may develop. There is a marked 
derangement of the nervous system at this period, affecting 
even the mental condition. The woman may exhibit slight 
vagaries, a loss of interest in the daily affairs of life, and 
in extreme cases even melancholia and other forms of in- 
sanity. 

A Mistake to Attribute All Symptoms at Middle Life 
to the Menopause. — It is a great mistake, however, to 
ascribe all disturbances occurring at .this time to "change 



THE MENOPAUSE 168 

of life." Many serious conditions have been overlooked 
by such superficial observation. Every symptom com- 
plained of should be investigated just as thoroughly as at 
any other age. 

THE PHYSIOLOGY OF THE MENOPAUSE. 

All the organs of generation become smaller at the 
climacteric and gradually cease to functionate. Many of 
the disagreeable sensations experienced at this period are 
due to the absence in the blood of the product secreted by 
the ovaries. Shrinking occurs in external as well as in- 
ternal organs, as shown by the wasting of the breasts. 

Importance of Familiarity with the Normal Phenom- 
ena. — Owing to her ignorance as to what constitutes the 
normal occurrences to be expected at the menopause, a 
woman is unable to recognize dangerous symptoms when 
they appear. Every year many women lose their lives in 
consequence of this ignorance. They view the danger sig- 
nals with complacency, regarding the warnings as part of 
the normal phenomena of the climacteric. It is, therefore, 
most important for every woman who has reached her 
fortieth year to acquaint herself with the normal symp- 
toms that accompany "change of life' 5 and to be able to 
recognize the symptoms of disease that frequently occur 
at the same time. 

THE RECOGNITION OF DANGER SIGNALS. 

When diseased conditions are present, Nature gives 
certain warnings which must be regarded if the disease 
is to be checked in time. The following phenomena are not 
normal: (i) Profuse bleeding at the time of the meno- 
pause; (2) Slight bleeding occurring oftcner than once in 
four weeks; (3) The apparent reappearance of menstrua- 
tion, or of slight irregular hemorrhages, after the meno- 



170 THE MENOPAUSE 

pause has been established and menstruation has been ab- 
sent perhaps for many months. 

Such symptoms should always be viewed with alarm. 
When they occur, a woman should immediately consult 
her physician. Any bleeding from the vagina in a woman 
who has passed the menopause should arouse the gravest 
suspicion. As a rule, it is usually caused by a diseased con- 
dition, usually by a tumor of some sort. If the tumor be 
a fungous growth, a polyp, or a fibroid, the condition may 
not be so serious as if it be a cancer. In the latter instance 
delay in seeking medical advice usually means death, while 
promptness may result in a cure. Penrose says of cancer of 
the cervix that "in the early stages the disease may be eradi- 
cated with every probability of a permanent cure," but that 
"the great majority of women come to the operator when 
the disease has extended too far to permit any radical treat- 
ment." 

HYGIENE OF THE MENOPAUSE. 

When entering upon the "change of life," a woman 
should carefully observe the rules of hygiene laid down in 
the first part of this book. It is most important that the 
general bodily health be maintained. Frequent warm baths 
are required to keep the skin acting well. The diet should 
be simple and unirritating. Meats should be restricted. 
An increase in the amount of vegetables eaten is advisable. 
Sugar is apt to set up a fermentation in the stomach; con- 
sequently sweet dishes, such as cakes, candies, preserves, 
jellies and sweet puddings must be taken in moderation, and 
when indigestion is present avoided altogether. The woman 
will also have to refrain from eating pastry, hot breads, fried 
food and rich dishes. She should drink water freely, taking 
three pints a day if possible. Stimulants are to be avoided; 
alcohol in any form is prohibited. The bowels are to be kept 



THE MENOPAUSE 171 

open, by suitable food and exercise or by purgatives or laxa- 
tives when required. An outdoor life is of advantage, gentle 
exercise in the open air being essential. Massage is benefi- 
cial, especially to those who for any reason are unable to 
take active exercise. It may be given twice a week by a 
skillful masseuse. 

The Turkish bath is an excellent form of exercise, com- 
bining the effects of massage and of the hot bath. It is par- 
ticularly useful at this period in distributing the blood 
throughout the body and in aiding the skin in getting rid 
of waste matters. It must not be taken, however, without 
the physician's permission or advice. 

The nervous system also demands attention. Domestic 
burdens should be lightened and the woman should be re- 
lieved of worry and responsibility as much as possible, but 
she must not be left without congenial occupation. Some 
form of amusement should be provided. A change of lo- 
cality and surroundings is sometimes demanded. In cer- 
tain cases it may be necessary to resort to the rest-cure. 

Pruritis or itching should be treated as described in 
Chapter XXXIII. 



PART III. 
CHILD-BIRTH. 







CHAPTER XIX. 

PREPARATIONS FOR THE CONFINEMENT. 



Have the best, if possible; if not, have the best possible under the circum- 
stances. The lying-in room. Arrangement of the bed. Things needed for 
the confinement: Absorbent pads, Occlusive bandages or napkins, The 
abdominal binder, The baby's basket, The baby's clothes, etc. Prepara- 
tion of the patient. Engaging the physician and nurse. The accoucheur: 
physician vs. midwife. The nurse: Trained nurse vs. monthly nurse. 
Selection of a nurse; her duties. 



"The readiness is all." — Shakespeare. 

N preparing for the confinement, one should know 
what is best to do and, if possible, put that knowl- 
edge into practice. But, unfortunately, a woman 
is not always able to do as she wishes. The best is 
oftentimes unattainable, in which case the best under the 
circumstances must suffice. Whenever possible the direc- 
tions given in this chapter should be implicitly followed; 
they are simple and necessary. However, persons who for 
any reason are unable to adopt the first and best sugges- 
tions made may be able to carry out the simpler methods 
also given, which, though less desirable, are yet serviceable 
and good. 

THE LYING-IN ROOM. 

The room usually selected for the confinement is the 
prospective mother's own bed-room. It ought to be large 
and sunny, well lighted, well ventilated and properly 
heated. A communicating room for the nurse is a great 
convenience, leaving the mother the exclusive use of her 
own. Matters are also made easier if the bath-room be 

175 



178 PB.EPAE.ATIONS FOB TUT: CONFINEMENT 

near. All unnecessary furniture, heavy curtains, and all 
bric-a-brac should be removed. If a carpet is on the floor 
it may be taken up, or the portion about the bed may be pro- 
tected by a large rubber mackintosh, or oilcloth, or by sev- 
eral layers of newspaper. A rug should be removed. It 
is well to take out of the room anything that might collect 
dust, which often is a carrier of disease germs. 

The Arrangement of the Bed. — The bed should prefer- 
ably be narrow and high and placed where it will be out 
of draughts. As it must be accessible from both sides, it 
should not be placed with its side against the wall. The 
mattress should be firm; hair is the best material. To 
prevent its sagging in the middle, three table boards, or 
shelves from a book-case, may be placed in the middle of 
the bed between the mattress and the spring. 

When the bed is arranged for the labor, draw-sheets 
of rubber and cotton are sometimes placed across the middle 
of the bed over the under sheet. This is known as the 
permanent bed, but, though convenient and elegant, is often 
dispensed with. Over the "permanent bed," when it is 
used, otherwise over the mattress, are placed a second 
rubber draw-sheet and a second cotton draw-sheet, some- 
times folded once. These constitute the temporary bed 9 
which is removed immediately after delivery. 

If the bedstead is double, instead of single, the tem- 
porary bed is arranged at the side where the patient is to 
lie, being securely fastened with large safety pins. Instead 
of the rubber sheet, a piece of mackintosh may be substi- 
tuted, or a piece of oilcloth that has been thoroughly 
scoured. When these are not to be had, use may be made of 
an old clean comfortable or of clean wrapping paper or even 
of clean newspapers. 

On the spot where the hips will lie is pinned an ab- 
sorbent pad, which, as soon as soiled, is to be taken off and 



FUEPAKATXOltfS FOE THE CONFINEMENT 177 

burned, to be replaced by a clean one. Consequently sev- 
eral must be provided. They are best made of nursery 
cloth, consisting of two layers of muslin, each one yard 
square, with a layer of absorbent cotton, wood wool, jute, 
bran or sawdust, two to four inches thick, loosely quilted 
between them. They can be made at home or bought in 
the shops. They must be baked in the oven, or boiled for 
half an hour in a clothes boiler and thoroughly dried, then 
pinned up in a sheet and put away out of the dust. If 
towels or napkins or old pieces of muslin are used, they 
must be prepared in the same manner. 

It is well to have two sets of coverings, one for use 
during labor, and one to put on after the delivery. 

THINGS NEEDED FOR THE CONFINEMENT. 

The Occlusive Bandages or Napkins. — These are best 
made of carbolized gauze and salicylated cotton, which, 
however, are rather expensive. A cheaper dressing is made 
out of rolled absorbent cotton, or wood wool, and washed 
cheese cloth. Two thicknesses of the cotton, seven or eight 
inches long and four or five inches wide, are enclosed in a 
quarter yard of the gauze or cheese cloth and so folded as 
to make a pad (sixteen or eighteen inches long and four or 
five inches wide), the edges being stitched. 

Sometimes old pieces of muslin or other material, which 
have been boiled, are used. Three or four dozen will be 
required. The hands that make them must be scrupulously 
clean. When made beforehand they should be put into a 
clean pillow case, or wrapped in a sheet, and thus boiled, 
steamed or baked. They then should be kept covered and 
put away in a clean place, free from dust. 

The abdominal bandage or binder is made of washed, 
unbleached muslin, about a yard and a quarter long and 
about half a yard wide. Sometimes it is made only long 

12 




178 PREPARATIONS FOR THE CONFINEMENT 

enough to go around the abdomen once, in which case it 
is furnished with buttons and buttonholes in front and laces 
at the sides. It must be firm to give the stretched muscles 
support, but care must be taken not to have it fastened 
tighter above than below. 

Other Articles Required. — There should also be in the 
lying-in room a table, a chair, two basins and a bucket. 

The woman should have the following articles on hand, 
ready for the confinement. The absolutely necessary things 
are given in italics; the full list can only be obtained by the 
well-to-do. Hand towels, ether (one-half pound), brandy (two 

ounces), vinegar (four ounces), 
tincture of green soap (four 
ounces) or anew cake of pure soap, 
antiseptic tablets of corrosive sub- 
limate (one bottle), a large, 
Bed-pan. coarse, new sponge; a skein of 

bobbin (sterilized), a fountain 
syringe, a bed-pan, a new soft rubber catheter, absorbent 
cotton (a small package), salicylated cotton (a one-pound 
package), carbolized gauze (five yards), nursery cloth 
(eight yards), unbleached muslin (two yards), large safety 
pins, carbolated vaseline (a one-ounce bottle), fluid extract 
of ergot (one ounce), a pair of scissors to cut the cord. 

As soon as the labor has begun, three pitchers should 
be filled with water that has been boiled for half an hour 
and clean towels should then be tied over their tops. This 
is the only water to be used about the patient. 

THE BABY'S BASKET. 

The baby itself must not be forgotten. A basket for 
the baby's things must be purchased or made at home. The 
cheapest arrangement is to buy an ordinary wicker hamper 
or shallow basket and a camp stool. The basket is attached 



PREPARATIONS FOR THE CONFINEMENT 179 

firmly to the camp stool, lined with muslin and trimmed 
with silk, lace and ribbon or other suitable material, with 
a pocket at each corner. The frill from the basket covers 
the place where it joins the camp stool. The basket should 
contain large and small safety pins, a bath thermometer, 
talcum powder, a line, soft sponge, a soft hair brush, castile 
soap, cold cream, alcohol for rubbing, blunt scissors for the 
nails, six wash-cloths of Shaker flannel, six inches square, 
old linen for cleansing the mouth, and a bath blanket. 

THE BABY'S CLOTHES. 

The following list of clothes will be required for the 
baby. In stating the number needed, two figures are given, 
the least number one can get along with and the number 
one ought to have. A mother may be able to economize still 
further by washing frequently and thus using the same gar- 
ment again: Four to six flannel or knit bands or binders; 
three to six dozen diapers ; four to six pairs of knitted woolen 
socks; three to four woolen shirts; four flannel night-skirts; 
four flannel day-skirts; four to six white day-skirts; six to 
ten slips; six to ten dresses; material for four or five flannel 
bands; a soft pillow, fourteen by eighteen inches; soft pillow 
covers; knit wrapping blankets; sacques, wrappers, bibs, 
caps, blankets, veils, and so forth. 

The way these clothes are to be made is described in 
Chapter XXVII on "Clothing for the Infant and the Child:' 

Other Conveniences for the Nursery. — Several other 
articles will be needed for the baby. They are: 

A bath-tub and two flannel bath aprons* 

Six old, soft damask towels. Bathing towels made from 
diaper cloth will answer when the damask ones are unob- 
tainable. They should be repeatedly scrubbed and boiled 
to be rendered soft. 



* Described in Chapter XXVI on "Bathing the Baby." 



ISO PREPARATIONS FOR THE CONFINEMENT 

A small-sized clothes bars or clothes horse. This will be 
used for airing the baby's clothes and holding its towels. 

A low chair without arms. This is for the nurse to sit 
on when washing the baby. 

A screen. It should have a firm, square frame, solidly 
covered with cretonne, burlap or denim, so that it will afford 
real protection from draughts or light. A bamboo screen 
with curtains hung on rods will not answer. 

PREPARATION OF THE PATIENT. 

When the time for confinement approaches, a woman 
should keep her bowels loose, by means of laxatives if neces- 
sary. As soon as she begins to experience the pains she 
should be given a rectal enema containing a pint of soap- 
suds and a teaspoonful of turpentine. She should take a 
warm general bath and should wash the external genitals 
thoroughly with soap and warm water. She should not 
take a vaginal douche unless she is subject to a contagious 
discharge, or unless she has been so instructed by the doctor. 

ENGAGING THE PHYSICIAN AND NURSE. 

The Accoucheur. — As soon as pregnancy is suspected, 
the physician should be engaged. He should have general 
supervision over the life of the woman, her diet, clothing, 
exercise, and so forth, during the whole period between 
conception and labor. 

Pregnancy, although usually a normal process, is sub- 
ject to various complications, for whose recognition and 
treatment a physician is required. The kidneys, in par- 
ticular, need constant watching, as they frequently become 
affected during this period. A four-ounce specimen of 
mixed night and morning urine should be sent to the phy- 
sician for examination every two weeks until the last 




EXERCISES FOR DEVELOPING THE FIGURE. 

i. Forward drop in a narrow doorway, 2. Breathing exer* 
rises combined with arm movements. 3. Arm exercises. 4. Bend- 
ing to the side. 5. Bending backward. 6. Bendi ard. 






PREPARATIONS FOE THE CONFINEMENT 131 

month, when it should be sent every week. A statement of 
the exact amount of urine passed during the twenty-four 
hours should accompany the specimen. 

When such symptoms as scanty urination, severe head- 
ache, dizziness, or swelling of the feet or face occur, they 
should be reported to the physician at once. 

A midwife, in the opinion of the writer, is not desirable, 
except in those cases where it is impossible to secure the 
services of a physician or a medical student. The midwife 
rarely understands the meaning of surgical cleanliness, 
which is the most important factor in preventing infection 
or blood-poisoning. She, moreover, is unable to meet the 
various complications as they arise, but always must send 
out for a doctor, who often arrives too late. Promptness at 
such a time in recognizing and meeting a serious condition 
is all-important. 

The Nurse. — A woman must choose between a trained 
nurse and the so-called monthly nurse. 

A trained nurse or graduate nurse, one who has com- 
pleted a course of training in a hospital, should be procured 
if she can be afforded. Such a person not only has the 
requisite knowledge as well as experience, but she has 
learned how to obey the orders of the physician. 

The monthly nurse, on the other hand, has not had care- 
ful hospital training, being merely a woman who makes a 
practice of nursing maternity cases for thirty days. Never- 
theless she often has acquired skill and experience with 
constant practice. Some monthly nurses, indeed, are very 
capable, and many are adaptable and able to carry out the 
doctor's orders in an intelligent manner. Frequently, how- 
ever, they arc filled with wrong ideas and queer, old-fash- 
ioned notions about the care both of mother and baby. 
Oftentimes they feel their experience to be of such great im- 
portance that they pay no attention to the advice or orders 



182 PREPARATIONS FOB THE CONFINEMENT 

of the physician; they regard the care of the patients as 
their own particular business rather than the doctor's. In 
consequence, the monthly nurse is often directly responsible 
for much injury to mother and child. Still she is always a 
great help in the absence of any one better, and she is all 
the majority of women are able to afford. 

The selection of a nurse should receive careful consid- 
eration. The woman must be known to be competent. 
It is not safe to employ a woman who is not known. 
Often the physician is able to recommend some one in whom 
he has confidence. In addition to ability, the nurse must 
have certain favorable personal qualities. She must be able 
to adapt herself to circumstances, to improvise when she can- 
not procure the object she requires. She also must possess 
tact, so as to get along with the family and the servants. 
Honesty and honor are two necessary traits: the first, be- 
cause the nurse sometimes is almost in charge of the house 
and always has access to every part; the second, because 
there is no family secret kept from the nurse, no skeleton she 
does not see. 

The duties of the nurse comprise everything that has 
to do with the care of both patients. She tends to the 
mother, washes her, arranges her meals, and so on, and at 
the same time takes charge of the baby, bathing it and car- 
ing for it in every way. 

The nurse, ordinarily, does not perform any work out- 
side of her own particular duties. She is not expected to 
wash the baby's clothes, with the exception of the diapers 
and flannels, nor wash her own garments, nor do the gen- 
eral cooking or sewing or cleaning. She may do all these, 
however, if she be so disposed, or if she be engaged with 
that understanding. The patient's meals, however, she is 
supposed to prepare. Where no servants are kept, the 
monthly nurse often prepares the meals for the family, and 



PREPARATIONS FOR THE CONFINEMENT 183 

when not engaged in caring for her patients may tend to 
some of the other household duties. 

The nurse must be properly cared for, in order that she 
maintain her own health as well as keep at the highest point 
of efficiency. Provision should be made for her obtaining 
sufficient sleep and getting some outdoor exercise every day. 
It is in relieving the nurse at such times that solicitous rela- 
tives can be of most service. 

The nurse should be engaged several months before the 
expected confinement. At this time all arrangements about 
the work to be done and the compensation to be received 
should be definitely settled. 

As the day for the confinement approaches, the nurse 
should be within reach, and a few days beforehand, espe- 
cially if the patient has already borne children, she should 
go to the house and remain there until after the confine- 
ment. She should, of course, be able to recognize the signs 
of labor and to know when to send for the physician. As 
soon as the process has begun she should arrange the bed 
and prepare the patient. 




A STUDY IN PENSIVENESS. 

These exquisite- heads, with their soft contours and delicate 
coloring, arc a marvel of beauty. The faces by the magic of the 
artist's brush bespeak rare kindliness, sanctity and loveliness. 



CHAPTER XX. 

THE PHYSIOLOGY OF CHILD-BIRTH. 



Causes of labor. How to calculate the day of confinement. The duration of 
pregnancy. Methods of calculation. Importance of knowing the date of 
the last menstruation. Child-birth: The first stage of labor; the second 
stage; the third stage. The Puerperium. The lochia's amount and odor. 
The danger signals. Afterpains. Changes in the breasts. 



"A mother is a mother still, 

The holiest thing alive." 

— Coleridge. 



S has been told in previous chapters,* when the pollen 
from the stamens of the apple blossom falls upon 
the pistil and is carried to the ovary, it fertilizes the 
ovule that lies within. The ovary thereupon grows 
bigger and bigger, developing into the fruit which contains 
the seeds from which are to spring new apple trees. As the 
apple becomes fully ripened, certain degenerative changes 
occur in the stem supporting it, which makes its connec- 
tion with the parent branch so frail as to be easily broken. 
A breath of wind will cause it to fall to the ground. 

The phenomena that occur in animals are much sim- 
ilar. As the ovum which contains the unborn offspring 
reaches full maturity it becomes separated more or less 
from the wall of the uterus by means of a degenerative 
process and is finally expelled, in human beings at the end 
of about forty weeks. 

Causes of Labor. — Every four weeks, as has been 
shown, t the womb has a tendency to contract. In the non- 

* See Chapters VIII and XV. 
fSce Chapter X. 

186 



ISO THE PHYSIOLOGY OF CHILD BIRTH 

pregnant uterus this results in the expulsion, in the form 
of the menstrual flow, of the blood that has accumulated 
there. During the development of the child this monthly 
contraction is hardly noticed until the end of the tenth lunar 
month, when the separation between the ovum and the 
womb is complete. By this time the distension of the uterus 
has become so great that the slightest additional impulse 
stimulates it to contraction. 

When a ship is ready to be launched, a single blow 
from a hammer will start it down the ways. So with the 
uterus when at the end of two hundred and eighty days it 
has been overstretched with a ripened ovum, the occurrence 
of the monthly contraction — or a little extra exercise, or a 
dose of purgative medicine, or a jolt, or a jar — will be suffi- 
cient to stimulate it to expel its contents. In this manner 
pregnancy is terminated by the birth of the child. 

HOW TO CALCULATE THE DATE OF CONFINEMENT. 

It is important for a woman to be able to estimate 
with some degree of accuracy on what day she will be con- 
fined. All her preparations are made in accordance with 
this calculation. The nurse is engaged for a certain date. 
The physician arranges his work so as to be ready for a 
call at the expected time. Not only is much unnecessary 
trouble and annoyance given to mother, doctor and nurse 
by lack of accuracy in calculating the date of the confine- 
ment, but the baby may come at a time when no prepara- 
tions have been made for its reception. 

THE DURATION OF PREGNANCY. 

Confinement is said to occur about two hundred and 
seventy-one days from the date of conception. As it is 
impossible to determine accurately just when conception 
occurs, it is customary to make the calculations from 



THE PHYSIOLOGY OF CHILD BIRTH 187 

the menstrual period immediately preceding conception. 
Labor may usually be expected to begin two hundred and 
eighty days after the first day of the last menstruation. 
Pregnancy, therefore, lasts about forty weeks, or ten lunar 
months of twenty-eight days each, or a little over nine 
calendar months. It is thus seen that labor comes on 
at the tenth menstrual period from the beginning of preg- 
nancy. 

METHODS OF CALCULATION. 

A very common way of calculating the date on which 
confinement may be expected is to start with the first day 
of the last menstruation, count backwards three months, 
and then add seven days. For example, if the first day of 
the last menstruation was on May ioth, counting three 
months backward would bring it to February ioth, and 
adding seven days would make February 17th the date on 
which confinement may be expected. This method will 
give only an approximate result, inasmuch as months are not 
of equal length. This difficulty is overcome by adding six 
days in April and September, five days in December and 
January and four days in February. 

Various tables have been compiled to make the comput- 
ing more accurate as well as simpler and easier. One com- 
monly used is given on the following page. This table is 
divided by horizontal lines into twelve parts, one for every 
month in the year. In each compartment are two rows of 
figures, the upper one being the days of the month in their 
regular order. To determine the probable day of confine- 
ment, find in this upper row the date of the first day of the 
last menstrual period; the figure immediately below it is 
the day of the month on which labor may be expected, the 
month itself being designated in the margin. For instance, 
if the last menstrual flow began on March 9th, the woman 
will probably be confined on December 14th. 



188 



THE PHYSIOLOGY OF CHILD BIRTH 



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THE BABY'S TOILET. 

This is a glimpse of a tidy home in a foreign land where the 
mother is giving baby its bath. See the directions for the Americn 
mothers to follow. 



THE PHYSIOLOGY OF CHILD BIRTH 189 

In these methods of reckoning, the date obtained must 
be regarded only as an approximate one. Labor may occur 
within the week preceding or the week following that date. 
It is the exception rather than the rule for labor to occur 
exactly in two hundred and eighty days. This figure is 
based on the supposition that menstruation occurs every 
twenty-eight days. 

Probably the very best way to estimate the duration 
of pregnancy is to ascertain the number of days between 
the last normal monthly period and the one preceding it, 
and multiply this number by ten. 

As the time of confinement is calculated from the 
first day of the last menstruation, it is most important for 
the woman to know just when this flow occurred. Many 
women, especially those about to be confined for the first 
time, fail to remember the exact date, thereby causing 
much worry and annoyance to themselves, to their family, 
and to the physician. 

The physician is able to estimate the duration of preg- 
nancy by noting the position of the womb.* 

CHILD-BIRTH OR LABOR. 

Labor is that natural process by which a woman expels 
from her uterus and vagina the matured ovum. This ovum, 
at the end of two hundred and eighty days, consists of the 
fully developed child, surrounded by the membranes, at 
one end of which is the placenta. 

THE THREE STAGES OF LABOR. 

Labor is divided into three stages. During the first 
stage the birth-canal expands until it is of a sufficient size 
to allow the child to pass through. The second act con- 
sists in the expulsion of the child. In the last stage the 

* See illustration in Chapter XV. 



100 THE PHYSIOLOGY OF CHILD BIRTH 



remainder of the ovum — the membranes and the placenta- 
is delivered. 

Before labor begins, the child usually lies head down- 
ward in a sack filled with water, the walls of the sack being 
formed by the membranes, which are everywhere in contact 

with the inner surface of the 



womb. The water contained 
in the sack and surrounding 
the child is called the liquor 
amnii, familiarly spoken of 
as "the waters." 

At the upper part of the 
uterus, between it and the 
membranes, is the placenta, 
which connects the large 
blood-vessels of the mother 
with the vessels in the um- 
bilical cord. 

Before labor begins the 
lower part of the womb is 
narrow, the neck is stopped 
up with a large plug of ten- 
aceous mucus, and the inter- 
nal mouth or os is tightly 
closed. 




Beginning of Labor. 
This is before the birth canal has 
become dilated. The thick cervix or 
neck of the womb is shown, opening at 
right angles into the long vagina. In 
front of the vagina is the bladder; be- 
hind, the rectum. 



THE FIRST STAGE OF LABOR. 

Labor begins with a series of contractions of the 
womb, lasting about a minute, and re-occurring at inter- 
vals of from five minutes to half an hour at first, usually 
of about fifteen minutes. The intervals decrease as labor 
progresses, finally being reduced to only two or three min- 
utes. 

The contractions drive the waters down through the in- 



THE PHYSIOLOGY OF CHILD BIRTH 



181 



ternal mouth into the neck of the uterus, where, covered only 
by the thin membranes, they dilate the neck and the inter- 
nal mouth easily and gently. As with repeated contractions 
the womb becomes smaller and smaller, the head of the 
child is driven down in the same direction as the bag of 
waters and further distends the lower part of the uterus and 
its neck, until at last the neck has been stretched so wide as 
to be completely obliterated. The same force then proceeds 
to dilate the outer mouth, or external os, until the latter is 
big enough to let the head through. 




The Uterus or Womb at the Beginning of tut. Imkst Stage 
of Labor, Before the Parts Have 1 f.p. 

o.i — Os Interims or internal mouth. <\r.— Os externus or 
external mouth. Between o.i, and o.e. lies the cervical canal. 

Just as this occurs, the membranes bulging in front 
usually rupture, allowing the waters to escape. Sometimes 
the membranes are so tough (hat they have to be punctured. 



192 THE PHYSIOLOGY OF CHILD BIRTH 

When the child is born with the unbroken membranes 
around it, it is said to be born with a caul. In some cases 
the membranes rupture early, causing what is known as 
a dry labor. With the full dilatation of the external os, 
the first stage ends and the second begins. 




The Uterus or Womb at the End of the First Stage, After 

the Parts Have Been Dilated. 

oi — Internal mouth or os. oe — External mouth or os. oi to oe — Cervical canal. 

THE SECOND STAGE OF LABOR. 

During the second stage of labor the head descends 
through the vagina, advancing slowly and stretching ail 
the tissues before it. Now, not only does the uterus con- 
tract, but the abdominal muscles also are brought into play 
and help to drive the child downward through the birth- 
canal. The moulding and stretching of the parts to fit the 
child usually takes about an hour and a half or two hours. 

At the end of this time the whole birth-canal will have 



THE PHYSIOLOGY Q? 0H1L.B BIRTH 193 

been fully dilated. The vulva, or external opening, then be- 
gins to distend, and when the aperture is sufficiently large, 
the head passes through, followed shortly after by the rest 
of the body. With the birth of the child the second stage 
ends. 

THE THIRD STAGE OF LABOR. 

After the expulsion of the child the uterus continues to 
get smaller. As the uterus contracts the placenta becomes 
detached from it and lies within the womb until, with 
further contractions, it is finally driven out into the dis- 
tended cervix or into the vagina, with the membranes 
attached to it and trailing after it. 

Having expelled the placenta, the uterus contracts until 
its cavity is obliterated. It then remains firmly contracted, 
squeezing the ends of the blood-vessels that were broken 
when the placenta was torn loose, and thus preventing 
hemorrhage. Labor itself terminates with the expulsion of 
the placenta or after birth. 

THE PUERPERIUM. 

The period immediately following the delivery of the 
child and the after-birth, comprising the time consumed by 
the uterus in regaining its natural size, is spoken of as the 
puerperal state, or the puerperium, or the lying-in period. 
In a normal case it lasts six weeks. 

The process by which the womb becomes reduced di- 
rectly after labor to the size of the healthy, non-pregnant 
organ is called technically "the involution of the uterus." 
It is brought about in two ways. The tissues of the womb 
shrink, while part of them becomes converted into fat and 
is expelled with the discharges. 

The Lochia. — This discharge, which always occurs after 

labor and is called the lochia, consists of blood, degenerating 

tissue, and the normal secretion of the parts. For the first 
13 



194 THB PHYSIOLOGY OF CHILD BIRTH 

five days it is red in color, from which it takes the name of 
lochia rubra, or red discharge. During the next two days 
it is yellow and is called lochia serosa. It then assumes a 
whitish color and is known as lochia alba. This last stage 
lasts until the seventh to the fourteenth day, or even longer. 

The amount of the discharge is conveniently estimated 
by noting the number of napkins or pads soiled in the 
twenty-four hours. These pads for the first four or five days 
should not normally have to be changed oftener than six 
times in the twenty-four hours. 

The odor of the discharge is an index as to the condi- 
tion of the patient. It should resemble that of fresh blood 
or raw meat while the discharge is red, but thereafter it 
should be that peculiar to these parts. 

When decomposition occurs the odor becomes putrid. 
This is an important danger signal. When it occurs the 
physician must be notified at once; the woman's life may be 
in peril. 

AFTER-PAINS. 
For several days after labor in women who have 
already borne children the muscle of the uterus relaxes a 
little at times. This loosens the hold on the broken blood- 
vessels and permits them to bleed slightly. The blood that 
oozes out in this manner collects in the uterine cavity 
where it forms clots of considerable size. These clots act 
as an irritant to the womb, exciting it to active contractions 
in an effort to expel them. The contractions of the uterus 
cause pains or cramps, which are known as after-pains. 
They continue until the clots are expelled. 

DIFFICULTY OF URINATION. 

The muscles of the abdomen are so worn out and 
strained after labor that sometimes for several hours or 
days they cannot act in emptying the bladder, which organ 



'THE PHYSIOLOGY OF CHILD BIRTH 195 

consequently becomes distended and must sometimes be 
relieved by means of a catheter. This may be used only by 
a physician or graduate nurse, and only after the failure of 
the various expedients to induce the voiding of urine volun- 
tarily, described in Chapter XXII on "The Care of the 
Mother After Labor." 

CHANGES IN THE BREASTS. 

During the latter part of pregnancy a thin, glistening 
fluid, called colostrum, is found in the breasts, from which 
it may be squeezed out. Directly after labor it is increased 
in quantity and becomes a little whiter and more opaque. 
At the end of about forty-eight hours the breasts undergo 
a decided change; they suddenly enlarge and may become 
very tense. Sometimes they are painful and tender on 
pressure, and impart a hard and lumpy sensation to the 
touch. The veins under the skin enlarge and show very 
distinctly. Instead of colostrum, the breasts now contain 
normal human milk, which is described in detail in Chapter 
XXIV on "Breast Feeding." 

The management of the mother, both during and after 
labor, is given in the following chapters. 



CHAPTER XXI. 



THE MANAGEMENT OF LABOR. 



The knowledge required to make a woman helpful in the lying-in room. The 
Diagnosis of Labor: "Dropping," labor pains, the show. Duration of labor. 
Surgical Cleanliness the Guiding Factor Throughout the Labor; A talk on 
germs; How the birth canal becomes infected; Puerperal infection can 
always be prevented; How to prevent puerperal infection. The Manage- 
ment of the First Stage of Labor: Diet during the first stage; The adminis- 
tration of an anesthetic. The Management of the Second Stage of Labor. 
Care of the New-born Infant: Care of a premature infant; Treatment of an 
asphyxiated baby. Care of the Mother During the Third Stage of Labor. 



"The hour arrives, the moment wish'd and fear'd ; 
The Child is born, by many a pang endear'd. 
And now the Mother's ear has caught his cry ; 
Oh, grant the Cherub to her asking eye ! 
He comes — she clasps him. To her bosom press'd, 
He drinks the balm of life, and drops to rest." 

— Rogers. 



T is not the author's purpose in this chapter to write a 
treatise on obstetrics. Nor is it his intention to so 
instruct a woman that she will be qualified to assume 
full charge of a labor. It must not be supposed that 
with a few minutes' reading a person can become proficient in 
what requires years of study and practice to acquire. The 
delivery of the child, known also as child-birth, labor, obstet- 
rics, parturition, midwifery and tokology, is too serious a pro- 
cedure to be entrusted to any but the most skillful hands. A 

196 




Copyright, 1903. by William H. Rau, 

THE BRIDE. 



All the wdrld loves a lover and stops to do homage to the lovely 
bride, whether she appears in the simple homemade gown, o 

more elaborate bridal gown, amid palms and flowers. 



THE MANAGEMENT OF LABOB 197 

physician should be engaged whenever possible; next in order 
of proficiency come the medical student and the midwife. 

In assisting the physician, however, a woman can be of 
great service, especially if she is familiar with the work required 
of her. The present chapter will be devoted to instructing a 
woman in the requisite knowledge that will make her presence 
valuable in the lying-in room. 

Before the date of the expected confinement, which is to 
be calculated according to one of the methods given, the prepa- 
rations for it mentioned in chapter XIX must be made. The 
occlusive bandages, the abdominal binder and the other articles 
required, including the baby's clothes and the baby's basket, 
should be in readiness. 



THE DIAGNOSIS OF LABOR. 

It is important for a woman to be able to recognize when 
she is in labor, in order, on the one hand, to summon the physi- 
cian in time, and on the other to avoid ludicrous mistakes. 

"Dropping." — A valuable premonitory sign is the "drop- 
ping" or sinking of the child's head in the pelvis, which is asso- 
ciated with a flattening of the upper part of the abdomen and a 
greater prominence of the lower portion. This may occur over 
night at the beginning of the last month of pregnancy in women 
who have never borne children, and two weeks or less before 
labor in a woman who is already a mother. 

Labor Pains. — The sign that labor has actually begun is 
the occurrence of labor pains. These are of a characteristic 
duration, situation and nature. They last but a minute and are 
separated by intervals of from live minutes to half an hour, 
being usually about fifteen minutes apart. The pain is felt in 
the abdomen or in the back, or it may seem to pass from the 
navel to the spine. 

The Show. — As the neck of the womb stretches, there is 



188 THE MANAGEMENT OF LABOR 

a slight oozing of blood which stains the large plug of mucus 
that fills the cervical canal. With the further dilation of the 
neck or cervix this blood-stained plug of mucus is expelled, 
when it is known as the "show." 

DURATION OF LABOR. 

It would be a most desirable thing if one were able to esti- 
mate just how long a labor will last. This, however, cannot be 
done with any degree of accuracy. The duration may vary 
from one hour or less to many hours, and in rare instances to 
a week or more. Women who have already borne children are 
in labor on an average about eight hours; those having their 
first baby must expect to be confined double that time or longer. 
The probable length of time may often be judged from the his- 
tory of a woman's previous labors. The author believes that 
the process will be much shortened in a strong, healthy woman 
who has lived hygienically and has taken plenty of exercise, 
especially if she has practiced those movements that strengthen 
the abdominal muscles. 

SURGICAL CLEANLINESS THE GUIDING FACTOR THROUGHOUT 

LABOR. 

A Talk on Germs.— Disease germs or bacteria are very 
minute ; thousands could be present on the head of a pin with- 
out being seen with the naked eye. These microscopic organ- 
isms multiply with great rapidity; in the course of several hours 
two or three individuals can increase to billions. Whenever; 
disease germs get inside the body they manufacture a poison 
which may produce disease and even cause death. While dan- 
gerous wherever found, they are especially so in certain locali- 
ties, such as the interior of the womb and of the abdomen, in 
the latter place giving rise to peritonitis. 

The introduction of a disease germ into the body is called 



THE MANAGEMENT OF LABOR 189 

infection. The presence of such a germ in the body is known 
as sepsis. Any article that has a germ on it is said to be in- 
fected or septic. By disinfecting or sterilizing an object we 
remove all germs from it and render it aseptic, sterile or sur- 
gically clean. There is consequently an important difference 
between ordinary cleanliness and surgical cleanliness. The 
former signifies that all dirt has been removed; the latter that 
all germs as well as dirt are absent. 

How the Birth Canal Becomes Infected. — Disease germs 
are never normally present in any of a woman's organs of gen- 
eration. They must come from without. When present in any 
part of the birth canal they have as a rule been introduced by 
the finger or hand, by an implement or instrument, or by the 
water. They can, however, themselves effect an entrance if 
deposited upon the external parts by one of the agents men- 
tioned or by the bed linen, the body clothing, the mattress, the 
vulvar pads or by the material used to wash the vulva or ex- 
ternal parts (rags, cloths, sponges, cotton, etc.). As soon as 
any germs have been introduced into the birth canal they are 
liable to multiply and cause both a local inflammation and a 
poisoning of the whole system. Such a condition occurring 
after labor is known to physicians as puerperal infection, puer- 
peral sepsis or puerperal fever, and more popularly as child- 
bed fever or blood poisoning. 

At any time other than during labor or shortly after it, 
the introduction of germs into the vagina is not attended with 
such serious results, because the cervix or neck of the womb is 
usually tightly closed and shuts off the germs from the parts 
above. But during the period from the beginning of labor, 
when the cervix begins to dilate, to the end of the puerperium, 
when it has firmly contracted again, a germ can easily travel 
through the open neck, then out the tube, and finally enter the 
abdominal cavity. In the womb the germ produces a septic 
inflammation; in the tube it may cause an inflammation, going 



200 THE MANAGEMENT OF LABOR 

on to the formation of an abscess known as a pus tube ; in the 
abdomen it will set up a peritonitis. All these conditions 
give rise to blood poisoning. 

Puerperal Infection Can Always be Prevented. — Know- 
ing how child-bed fever is caused, it is possible to prevent it. 
If germs are never introduced into the birth canal they can do 
no damage there. The entrance of germs is prevented by not 
inserting into the vagina of a woman in labor, or even bring- 
ing in contact with the parts, anything that is not surgically 
clean. Some women indeed are lucky and may have germs in- 
troduced without suffering any evil consequences. But the 
majority are bound to pay the penalty. Most of the deaths 
that have occurred during or shortly after child-birth have been 
caused by puerperal infection, a preventable disease. If a 
woman should regard the precautions given in this chapter as 
being too troublesome and "fussy," let her reflect that they 
save human lives. Anything less is fraught with danger. No 
better picture of the result of carelessness and negligence can 
be given than the one presented by the physician and man of 
letters, Oliver Wendell Holmes : 

"It is as a lesson," he says, "rather than as a reproach, that 
I call up the memory of the irreparable errors and wrongs. No 
tongue can tell the heart-breaking calamity they have caused. 
They have closed the eyes just opened upon a new world of love 
and happiness ; they have bowed the strength of manhood into 
the dust; they have cast the helplessness of infancy into the 
stranger's arms, or bequeathed it, with less cruelty, the death 
of its dying parent. There is no tone deep enough for regret, 
and no voice loud enough for warning." 

How to Prevent Puerperal Infection. — The only way to 
prevent puerperal infection is to keep disease germs out of the 
woman's vagina. This is accomplished by observing surgical 
cleanliness or asepsis. Nothing that is not sterile must enter 
the birth canal. In addition to this there must be ordinary 



THE MANAGEMENT OF LABOR 201 

cleanliness in everything concerning the woman. It is partly 
on account of their knowledge of asepsis that the physician is 
to be preferred to the midwife and the trained nurse to the 
monthly nurse. 

All the directions given in Chapter XIX concerning the 
preparations for the confinement are to be rigorously followed : 
the room, the bed and the dressings should be made ready in 
the manner described. The rules laid down in this and the fol- 
lowing chapter must be obeyed to the letter. Only water that 
has been boiled may be used about the patient, even when it is 
to be made up into a disinfectant solution. All articles that 
come in contact with the woman in labor should be boiled for 
at least five minutes, or if boiling would injure them they should 
be immersed for half an hour in a disinfectant solution, such 
as bichlorid of mercury i to iooo or carbolic acid I to 20. 

But it is not sufficient that everything employed about a 
woman in labor be rendered aseptic; it must be kept so. The 
moment a sterile object touches something that is not sterile 
the object is itself no longer sterile, but has become infected. 
An instrument that has been boiled remains aseptic or sterile if 
held in a hand that has been sterilized, but when touched by a 
hand that has not been rendered sterile it is no longer surgically 
clean. Consequently before they can touch any object or any 
part of the patient which is to remain sterile the hands them- 
selves must first be sterilized. 

A common and efficient method of sterilizing the hands is 
to scrub them for ten minutes with a nail brush, tincture of 
green soap and hot water, the latter being changed several 
times, and follow this by a thorough scrubbing with alcohol 
and then by an immersion for at least two minutes in a 1 to 1000 
bichlorid of mercury solution. After this process the hands 
must not touch anything that is not sterile, for a hand that has 
been thoroughly sterilized becomes infected as soon as it touches 
the face or dress or any other object which has not been ren- 



202 THE MANAGEMENT OF LABOH 

dered aseptic. Consequently, should a person with sterile hands 
inadvertently touch something not surgically clean, should she 
for example scratch her face or brush her hand against her 
dress, she must immediately immerse her hands in the bichlorid 
solution or even scrub them again before so doing. 

THE MANAGEMENT OF THE FIRST STAGE OF LABOR. 

During the labor, only the physician and the nurse 
should be in the lying-in room. Relatives and friends whose 
services are not required should be excluded. It is especially 
necessary to keep out those loquacious neighbors who de- 
light in describing serious or fatal cases which have come to 
their notice. The nurse, too, must refrain from alluding to 
any dangerous or harrowang cases she may have attended. 

As stated in Chapter XIX, the first step in the management 
of a labor is to give an enema of a pint of soapsuds containing 
a teaspoonful of turpentine. When gonorrhea is known or sus- 
pected to be present the vagina should be scrubbed with soap 
and water and then douched with a I to 2000 bichlorid solution. 
Under ordinary circumstances, however, a douche is unde- 
sirable. The hair may be brushed and arranged in two braids. 
After the bath, given as directed in Chapter XIX, the patient 
is dressed in a clean nightgown, wrapper and easy slippers. 
In cold weather she should wear in addition a thin woolen 
undershirt and woolen stockings. 

In the daytime the woman may then be up and about, 
walking about the room, sitting in a chair or lying on a lounge. 
During a pain she may obtain some relief by lying down or 
sitting with the body inclined forward, the hands grasping a 
chair in front. At night it is better for the woman to sleep. 
She is usually ordered to bed when the physician finds upon 
internal examination that the external os or mouth has reached 
the size of a silver dollar, although he often waits until the os 
is fully dilated. After this time the woman should never sit on 
a closet, but should always use a vessel of some sort. 



THE MANAGEMENT OF LABOH 203 

Diet During the First Stage of Labor.— When labor 
comes on in the daytime it is necessary at frequent intervals to 
supply liquid nourishment, such as milk, broths and the like, 
with a very small quantity of bread, toast or crackers. The 
woman should drink large quantities of water, plain or effer- 
vescent, and may be allowed a moderate amount of tea and 
coffee. 

The Administration of an Anesthetic. — Many physicians 
make a practice of giving an anesthetic when the pains become 
severe. Ether is the safest anesthetic. Ordinarily it is em- 
ployed not to put the woman to sleep, but merely to obtund the 
sense of pain. Ether must not be given too long; conse- 
quently it is administered as late in the labor as possible, being 
usually deferred until the second stage w T hen the abdominal 
muscles are brought into play. It is important not to give too 
much ether, therefore the anesthetic should not be given until 
just as the pain is coming on. A light towel is then thrown 
over the face, and as the patient exhales, a few drops are 
poured on the towel just below the tip of the nose, so that 
the vapor is sucked into the lungs as the patient breathes in. 
It takes only a little ether to obtund the sensibilities, and no 
more should be given than is necessary for this. As soon as 
each pain passes off the administration of ether should be 
suspended, to be assumed with the onset of the next pain. 

THE MANAGEMENT OF THE SECOND STAGE OF LABOR. 

As the second stage draws near, a large, clean, new sponge 
or some clean towels should be at hand to catch the waters 
when they break. With the advent of this stage of labor and 
the participation in it of the abdominal muscles the woman will 
want something to pull on to aid her in her bearing-down 
efforts. To supply this need a "puller" may be made by tying 
a twisted sheet, a roller towel or a rope to the foot of the bed. 
The woman pulls on this while she braces her feet against the 
footboard of the bed. 



204 THE MANAGEMENT OF LABOB, 

The patient will often feel better if the small of her back 
is pressed upon by the nurse or rubbed briskly or if a hot water 
bottle is applied to it. Occasionally washing the patient's face 
and hands w r ith cold water will prove very grateful. A cramp 
in the leg may be relieved by forcibly stretching out the limb, 
at the same time pulling the foot up toward the knee. 

As the time of actual delivery approaches, the nurse or 
attendant must see that everything is at hand. The patient 
should be placed in the desired position on her back or side. 
If on the latter, a clean pillow should be placed between the 
knees, or the upper limb should be supported by the nurse. A 
sterile obstetric pad is then placed beneath the hips and a sterile 
sheet is draped over the side of the bed or pinned around the 
waist with the side next the accoucheur left open and the long 
end fastened beneath the patient's arm. The physician should 
have within easy reach a basin containing a disinfectant solu- 
tion for his hands and another basin containing bits of cotton 
in an antiseptic solution. Near by should be the material for 
tying the cord and the scissors for cutting it, all of which must 
be sterile; a glass containing a warm solution of ten grains of 
boric acid to the ounce of water, pieces of soft linen and a medi- 
cine dropper ; and a bottle of fluid extract of ergot, with a tea- 
spoon. A sterile douche bag should also be in readiness, with 
sterile hot and cooled water and an aseptic bath thermometer. 

A warmed blanket should be at hand in which to receive 
the baby. Hot and cold water, which need not be sterilized, 
should be easily available in tubs, basins or buckets, for resusci- 
tating the infant should it be asphyxiated. 

Inasmuch as the actual delivery is the work of the physi- 
cian and of him alone, a description of it here would be out of 
place. Suffice it to say that the skill of an accoucheur con- 
sists in preventing tears and other accidents and in meeting 
the various complications as they arise. 

As soon as the baby's head is delivered the eyes are wiped 










V-:-/'^::^' 










THE MANAGEMENT OF LABOR 205 

with a piece of soft linen which has been soaking in the boric 
acid solution, more of the solution being introduced later by 
means of the medicine dropper. 

CARE OF THE NEW-BORN INFANT. 

As soon as the baby is born it is held by its thighs and legs, 
head downward, while the physician crooks his little finger, 
covered or not with a piece of old linen, and introduces it in 
the baby's throat back of the tongue, so as to clear the air 
passages of any blood or mucus that may have been inspired 
during the passage through the birth canal. The infant is 
then wrapped in a warmed towel and laid upon its right side 
with its face turned away from its mother. As soon as the 
umbilical cord has ceased to beat it is tied about two fingers' 
breadth from the child's body with a firm double knot, the ends 
of the string being then tied with a single and with a bow knot. 
The physician then places his hand upon the baby's abdomen so 
that the cord lies between the fingers, and holding the scissors 
close to those fingers with his other hand, he cuts the cord off 
on the outer side of the knot. The child is then wrapped in a 
warm blanket and put in a safe place, preferably its basket or 
crib. 

Care of a Premature Infant. — A premature child should 
be placed in an incubator. In its absence a clothes basket, bath- 
tub or wooden box may be used. This should be lined first with 
heavy wrapping paper and then with heated cotton or blankets 
and filled for half its depth with cotton wool. The child is laid 
in this and surrounded with hot water cans or bottles, and cov- 
ered all but its face and bottom with lamb's wool, cotton wool 
or cotton batting, held in place by gauze bandages. A piece of 
absorbent cotton or wool should be placed between the child's 
thighs. A blanket or shawl then covers the basket with the 
exception of the baby's head. The incubator is to be kept at a 
temperature of between 85 and 05 degrees Fahrenheit. 



206 



THE MANAGEMENT OF LABQB, 




A Premature Infant in an Incubator. 



The Treatment of an Asphyxiated Baby. — If the child 

does not breathe after birth, the cord should be immediately tied 
and cut as described below, and one of the following methods 
of inducing artificial respiration, or all in succession, should be 
tried. The child may be alternately folded and unfolded like a 
book, as shown in the accompanying -illustrations. It may be 
supported by the feet, with the forehead resting on a table, while 



THE MANAGEMENT OF LABOR 



207 




Folding and Unfolding an Asphyxiated Baby, 

in an Effort to Start tiif. Breathing. 

The various steps in the movement are numbered in order. 



light compression with the thumb and fingers is made on its 
chest about twenty times a minute. Wrapped in a towel and 



208 THE MANAGEMENT OP LABOR 

grasped by the shoulders, the baby may be swung first between 
the physician's knees and then over his shoulders. Another 
method is to stretch the baby's arms high above its head and 
then press them down to its sides. The child's neck may be 
placed over a mug, and through a clean towel spread over the 
child's face the physician may very gently blow a little air into 
the child's mouth. Slapping the buttocks and rubbing the back 
and chest vigorously may start the breathing. The infant 
should frequently be placed in a hot bath to prevent chilling. 
While in such a bath ice water may be poured on the chest and 
abdomen. Sometimes the shock of placing the baby alternately 
in hot and cold water will stimulate the respirations. 

CARE OF THE MOTHER DURING THE THIRD STAGE OF LABOR. 

Meanwhile the mother must be receiving attention. As 
soon as the child's body is born she must be given a teaspoonful 
of the fluid extract of ergot in a little water. At the same time 
the womb is grasped through the abdominal wall, with the palm 
of the hand placed above, the thumb in front and the fingers 
behind, and is rubbed, kneaded, squeezed and pressed upon to 
stimulate it to contract and thus prevent hemorrhage. After 
a while the uterus will be felt to contract firmly. Then during 
a pain the physician presses down the womb and squeezes out 
the after-birth. The kneading and pressing are continued for 
fifteen minutes more. All the soiled towels and pads are then 
removed, the parts cleaned, and those sheets known as "the 
temporary bed" slipped out. A sterile, folded, dry, warmed 
sheet or another sterile obstetric pad is then placed under the 
patient. A pad or compress, consisting of one or two folded 
towels, is laid above the navel, and the binder is adjusted so 
as to reach from the ribs to the hip bones, being pinned from 
above downward so as to fit snugly. Then with surgically 
clean hands the occlusive bandage is applied between the 
thighs and pinned to the binder both in front and behind. 



CHAPTER XXII. 

THE CARE OF THE MOTHER AFTER 

LABOR. 



The Prevention of Infection. Rest and Quiet: Position to be assumed in bed; 
Getting up; Visitors. Diet for a Nursing Mother. The Life of the Nursing 
Mother. Bathing During the Puerperium. Rules Concerning Urination. 
Attention to the Bowels. Care of the Breasts: Care of the nipples; The 
mammary binder; Emptying the breasts; Care and cleanliness; The treat- 
ment of congested and distended breasts. 



"Look here and weep with tenderness and transport ! 
What is all tasteless luxury to this? 
To these best joys, which holy Love bestows? 
Oh Nature, parent Nature, thou alone 
Art the true judge of what can make us happy." 

— Thomson. 



HE chief concern of both the physician and the nurse in 
charge of a woman after labor is the prevention of 
infection. This is attained by the same precautions in 
regard to surgical cleanliness as were necessary during 
the labor itself. Absolute cleanliness of the patient, of every 
one who attends her and of everything that comes in contact 
with her, will usually avert the commonest and most fatal com- 
plication of this period — puerperal sepsis. This is by far the 
most important consideration. There are other matters, how- 
ever, which add to the comfort and safety of the patient. 

The life of the woman must be carefully regulated both 



H 



*\JU 



210 CAHE OF THE MOTHEit AFTEE LABOR 

during the period immediately following labor and through- 
out the whole of lactation. 

REST AND QUIET. 

The mother must have absolute mental and physical rest 
for the first few days after labor. She must not be disturbed by 
loud noises or by a glaring light. For these first few days no 
extended conversation should be allowed in the lying-in room. 

Position to be Assumed in Bed.— The woman after deliv- 
ery should lie flat on her back, for the first six hours without a 
pillow. According to Hirst, she should remain on her back for 
at least a week. Davis, however, believes that this position, if 
too long continued, has a tendency to favor backward displace- 
ment of the womb. As soon as the patient feels rested and 
comfortable and there is no longer any danger from hemor- 
rhage or relaxation of the womb, the author permits his patients 
to move about in bed, turn on either side or lie upon the abdo- 
men, and after several days he allows the shoulders to be raised 
a little. The patient is then gradually propped up higher in 
bed until in a few days she can be placed in a sitting position. 

Getting Up.— The patient should be kept in bed until the 
womb has so shrunken in size that it has again returned to the 
pelvis and until there is no longer any blood in the lochial dis- 
charge. This state usually is reached in from ten to fourteen 
days. A safe rule would be for the woman to remain strictly 
confined to the bed for two weeks. If she gets up beforehand 
her womb is liable to be displaced. After the fourteenth day 
she may put on stockings, bedroom slippers and a flannel wrap- 
per and pass the day upon a lounge, rising to use the commode 
and sitting up as long at a time as she can without fatigue. As 
a rule she should not walk about the room for a week longer 
or go down stairs until the end of the fourth week. These 
directions, however, must often be varied to suit the individual 
case. 



CAKE OF THE MOTHER AFTER LABOR 211 

Visitors.-— The patient's husband and mother are the only 
visitors to be allowed in the lying-in room, and they must not 
come too frequently. Even they can remain for but a short 
time and must avoid exciting subjects in their conversation. 
All other visitors are to be excluded during the first week. 
After this period the patient's relatives and intimate friends 
may see her for a few minutes, if they be of cheerful disposi- 
tion. But the nurse must keep out those inquisitive "busy- 
bodies" who often come pouring into the room inquiring 
minutely as to the particulars of the case and offering sugges- 
tions and advice based on their experience with cases which 
they believe to have been similar and which they want to de- 
scribe in detail. 

THE DIET FOR A NURSING MOTHER. 

The diet during the first three days should be very light, 
consisting chiefly of milk, with the addition of toast or crackers, 
gruel mush, grits or boiled rice and a little stewed fruit or 
baked apples. Gradually soft-boiled eggs, custard, junket, 
light puddings, broths, soups, jelly, sponge cake, ice cream, a 
charlotte russe, fresh fruit and vegetables are added to the 
dietary during the first week. The white meat of fowls, sweet- 
bread, lamb chops, fish and oysters may be given during the 
second week, and beef, bacon and potatoes during the third 
week. The puerperal woman should avoid rich and indigestible 
foods and alcoholic drinks. 

Throughout the whole of lactation, the period during which 
she nurses her baby, the mother must be careful to eat only what 
is digestible and nutritious, observing all the directions given in 
chapter VI as to thorough mastication of the food and regular- 
ity in the time of meals. The diet may have to be modified as 
described in chapter XXIV, should it be necessary for any rea- 
son to alter the character of the milk. 

THE LIFE OF THE NURSING MOTHER. 

In addition to being careful about her diet, the nursing 
mother must take regular exercise in the open air. She must, 



212 CAEE OF THE MOTHER AFTER LABOE 

however, be kept free from fatigue, both mental and physical, 
and also from worry, anxiety or nervous excitement. Late 
hours are always to be avoided. Inasmuch as a powerful emo- 
tion, such as fright or violent anger, may render her milk unfit 
for use, a woman who has been subjected to such an influence 
should avoid nursing her baby for some hours afterward, 
emptying her breasts by means of a breast pump and giving 
the child barley water for one or two feedings. 

BATHING DURING THE PUERPERIUM. 

In the morning, about an hour after breakfast, the patient 
should be bathed in tepid water with a washrag and soap. In 
the evening she may receive a light alcohol rub. 

The genital region should be cleansed and dressed every 
four hours and after each evacuation of the bladder or rectum. 
The nurse, after seeing that everything she requires is at hand, 
places the patient on a douche pan and arranges the coverings. 
She then sterilizes her hands and, gently separating the labia, 
pours on the parts from a pitcher a disinfectant solution such 
as a I to 2000 bichlorid solution. The parts are then dried 
with bits of sterile cotton and a fresh sterile occlusive dressing, 
made as described in chapter XIX, is applied, being held in 
place by a T bandage or by pinning its ends to the abdominal 
binder. 

RULES CONCERNING URINATION. 

After labor there frequently is a tendency to retention of 
urine. If the woman is unable to pass her urine she should be 
placed on a warm bed pan or douche pan half full of warm 
water. If this fails, a hot application such as a turpentine stupe 
should in addition be made over the kidneys, bladder or external 
parts, or a clean sponge or a large piece of cotton wet with 
warm sterile water should be placed between her thighs, or the 
patient should listen to the sound of running water. Often if 
left to herself the patient is better able to urinate. Sometimes 




THE PRIDE OF THE HOUSEHOLD. 

II '//(•// the father first looks at his first bom in the arms of tin 
nurse or of the mother, a thrill of [vide and paternal love spring 
into his heart for the little life which has conic into the home. 



es 



CARE OF THE MOTHEE AFTER LABOR 213 

if raised by means of pillows to a semi-recumbent or a sitting 
position she can then empty her bladder. If these expedients 
fail and no urine has been passed six hours after labor, resort 
must be had to catheterization. This is to be entrusted only to 
the skilled hands of the physician or the trained nurse, and 
must be performed aseptically with all the precautions required 
by surgical cleanliness. Should any germs enter the bladder, 
they may set up an inflammation that is very difficult to cure. 
After this the woman is to be catheterized three times a day if 
necessary, in every instance recourse having first been made 
to each of the expedients mentioned above. 

ATTENTION TO THE BOWELS. 

Constipation is the rule after labor. At the end of forty- 
eight hours it is well to administer a laxative of some sort. The 
choice of the drug employed will depend upon the patient's in- 
clination or prejudice. Castor oil may be given in warm milk 
or in a frothy liquid, such as porter or soda water. A good 
plan is to give half a bottle of citrate of magnesia on the even- 
ing of the second day after labor, and the other half the follow- 
ing morning before breakfast. If the bowels do not move 
within two hours an enema should be given. 

CARE OF THE BREASTS. 

Emptying the Breasts. — The infant should be nursed at 
regular intervals of two hours, as described in chapter XXIV. 
When, owing to the death of the child, mechanical measures 
are necessary for emptying the breasts, a breast pump may be 
employed, the breasts at the same time being rubbed and mas- 
saged with oiled finger tips in a direction toward the nipple. 
Sometimes the use of massage and the breast pump is required 
to supplement the child's sucking when the latter is not suffi- 
cient to thoroughly evacuate the breasts. 

Care and Cleanliness. — The observance of care and clean- 



214 CARE OF THE 110THER AFTER LABOR 

liness in regard to the breasts and nipples is the best preventa- 
tive of subsequent trouble. The breasts should never be han- 
dled by either the nurse or the patient with fingers that are not 
thoroughly clean. 

Care of the Nipples. — After each nursing the nipples 
should be washed by means of some absorbent cotton with warm 
or cold water and castile soap or with a solution of boric acid 
10 grains to the ounce, and should then be dried with a soft 
cloth. After each washing the skin of the nipple and the sur- 
rounding parts should be anointed with sterile olive oil or sterile 
cocoa butter applied by means of fresh absorbent cotton or a 
piece of clean linen. A supersensitive nipple may often be 
relieved with extract of witch hazel. 

A nipple shield must be used when the nipple becomes 
chapped or cracked or when it is very tender or of such a size 
and shape that the baby cannot obtain a satisfactory hold. A 
glass shield with a rubber nipple is the one most frequently 
employed. It should be simple and should fit tightly. If filled 
with warm milk and inverted over the nipple the child will often 
take it better. It should be boiled after being used, and should 
be kept in a boric acid solution. 

A depressed nipple should be drawn out by means of the 
breast pump, suction being applied by a rubber bulb or by the 
mouth through a piece of rubber tubing, or a bottle should be 
filled with very hot water, emptied rapidly, and quickly inverted 
over the nipple. 

The Mammary Binder. — The support of the patient's 
breasts by means of the mammary binder will increase her com- 
fort and may prevent serious disturbances. There are many 
forms of this binder. The simplest is a straight bandage of 
unbleached muslin, properly shaped by darts, applied with a 
compress under the outer portion of each breast. The Murphy 
binder is likewise made from a straight piece of muslin, but has 
a notch for the neck and two deeper notches for the arms. 



CARE OF THE MOTHER AFTER LABOR 215 

Another bandage can be made out of a handkerchief folded as 
a triangle and passed under the breasts and tied behind the 
neck, the lower end being kept in position by being fastened 
with safety pins to the abdominal binder or to a strip of muslin 
or a bandage tied around the waist. One handkerchief may be 




Breast Supported by a Handkerchief. 

applied to each breast. The obstetrical breast support with 
knitted bosom is much less cumbersome and therefore more 
desirable when the patient is out of bed. 

The Treatment of Congested and Distended Breasts. — 
When the flow of milk is excessive the breasts may become dis- 
tended or even congested, despite all care. Congestion is apt 
to occur shortly after the breasts assume their function of sup- 
plying milk. Both conditions are treated by the dietetic and 
other measures mentioned in chapter XXIY for reducing the 
quantity of the milk. A purge must always be given. Cover- 
ing the breasts with sterile gauze will soak up the leakage and 
prevent it from soiling the clothing. Should the milk fail to 



216 CARE OF THE MOTHER AFTER LABOR 

escape, a condition known as caked breast results. This is best 
treated by washing the breasts with soap and water just before 
the child is nursed or the breast pump is applied, and then with 
aseptic hands gently rubbing warm sterile olive oil on them for 
ten to twenty minutes, massaging them from below upward 
and from the base toward the nipple. 

Preceding the massage hot fomentations or cloths soaked 
in lead water and laudanum may be applied for fifteen to twenty 
minutes, care being taken to cleanse the nipple thoroughly 
before putting it in the baby's mouth. When inflammation or 
an abscess develops the baby must be immediately taken from 
the breast and the physician summoned. 



PART IV. 
THE BABY. 



CHAPTER XXIII. 

APPEARANCE AND DEVELOPMENT OF 
THE NORMAL INFANT. 



Color and appearance of the skin. Shape and development of the head; the 
fontanelles. The face at birth. The baby's hair. An infant's tongue. The 
baby's gums. Cutting the Teeth: The first or milk teeth; the second or 
permanent teeth; Teething a normal process. The shape and appearance 
of an infant at birth; Position assumed by the baby. The infant's size and 
weight at different ages. The baby's bowels. The baby's urination. The 
other functions of the baby. 

"To aid thy Mind's development, — to watch 
Thy dawn of little Joys, — to sit and see 
Almost thy very Growth, — to view thee catch 
Knowledge of objects, — wonders yet to thee." 

— Byron. 

MOTHER should be familiar with the appearance of 
the healthy baby in order to be able to tell when 
it is abnormal or sick. The normal weight at dif- 
ferent ages should therefore be known. Unless the 
mother knows when the various teeth should be cut and 
when the child should begin to notice, she will be unable to, 
decide whether her baby is developing properly or not. 

COLOR AND APPEARANCE OF THE SKIN. 

At birth the skin is of a decided lobster red color and 
is covered thickly in many parts with a peculiar whitish, 
waxy substance known as the vernix cascosa. After this 
has been removed and the baby has been bathed, the skin 
is found to be soft and extremely delicate and covered 
with a coating of fine down, which begins to fall out dur- 

219 




230 



THE NORMAL INFANT 



ing the first week. By degrees the color fades into some 
shade of pink or, where a slight degree of jaundice is pres- 
ent, to a yellowish-red tint. As the infant grows older the 
color changes to a delicate pinkish white. 

SHAPE AND DEVELOPMENT OF THE HEAD. 

The head is large in comparison with the chest, being 
nearly as long as the trunk. The shape of the baby's head, 




Skull at Birth, Showing the Fontanelles. 



as seen from above, is normally round or oval, the circum- 
ference being about thirteen inches. The head of a newly- 
born child may have a startling shape, as the result of pro- 
longed pressure. One side may be flattened while the other 
bulges, or the head may be long and narrow. The idiotic ex- 
pression that such a shape sometimes imparts to an infant 
often causes much distress, alarm and anxiety to the parents. 
In almost every case, however, the abnormal appearance 
does not represent a permanent deformity but passes away, 
usually in a few days or a few months. No attempt should 
ever be made to squeeze the head into shape. 

Just behind the forehead is a diamond-shaped spot, 
about three-eighths of an inch to an inch and a quarter long 




< 

PQ 

w 
w 

H 

o 
PQ 



THE NOEMAL INFANT 221 

and seven-eighths of an inch wide, where the bone is absent, 
the brain being covered only by a thin membrane and the 
skin. This is known as the anterior fontanelle. Depression 
of this spot indicates that the child is not properly nour- 
ished. The spot seems to enlarge as the infant grows 
older, up to about the ninth month, but the increase may 
be apparent rather than real. From the ninth to the twelfth 
month it seems to remain about the same size; it then grad- 
ually becomes smaller and should be closed by the nine- 
teenth or twentieth month. At the back of the head is a 
smaller and less significant opening, known as the posterior 
fontanelle. 

The Face at Birth. — The face in infancy occupies only 
one-eighth as much space as the rest of the head. Not un- 
commonly, at birth, it. is swollen and the features are out 
of shape. This is usually due to pressure and will soon pass 
away. The eyes are of a dull, grayish blue, expressionless 
and almost always half open when the child is awake and 
entirely shut when it is asleep. Some time elapses before 
the child knows what it sees. 

The Baby's Hair.— The hair at birth is often thick, 
dark, and one or two inches long, but it may be short, fine, of 
a light brown shade, and small in amount, coming down 
to a round point on the forehead and leaving the temples 
bald. During the second and third weeks the first hair 
often falls out, that on the back of the head being worn 
away by the rubbing on the pillow. The new hair grows 
in very slowly and is of the same character as the first 
but lighter in color. 

An Infant's Tongue and Gums. — During the first week 
of life the tongue is comparatively dry, long and narrow 
and slightly coated. 

The gums at birth are of a light pinkish color, smooth, 
firm, and quite narrow, and rather sharp and hard at the 



S22 THE NOEMAL INFANT 

edges. Some months later the edges grow broader in front 
and become more prominent. 

CUTTING THE TEETH. 

The first teeth may appear at any time during the first 
year of life, usually about the end of the sixth or seventh 
month. They often are cut earlier than this, but may be 
delayed until the second year. The teeth usually come in 
groups, with an interval between the cutting of each group. 

Names and Time of Appearance of the Milk Teeth.— 
There are twenty milk teeth or temporary teeth, ten on 
each jaw. The two middle ones are called the central in- 
cisors; next to these come the lateral incisors, then the 
canines, next the anterior molars and finally the posterior 
molars. The canine teeth of the upper jaw are often spoken 
of as the eye teeth, those of the lower jaw as the stomach 
teeth. 

The two lower central incisors are the first to appear, 
coming through the gums about the seventh month. Then 
follows an interval of three weeks in which no teeth are 
cut. Between the age of eight and ten months the two 
central upper incisors push through, followed closely by 
the lateral upper incisors. Then there is another interval 
of from one to three weeks, ended by the eruption of the 
four anterior molars and the four lower lateral incisors, 
which appear one at a time, in no particular order, during 
the period between the twelfth and fifteenth months. No 
teeth are then cut for two or three months until the child 
is eighteen months old, when, during the next six months, 
the canines come through. After a third pause of two to 
four months the posterior molars make their appearance, 
which occurs between the twentieth and thirtieth months 
of life. 

The Second or Permanent Teeth. — There are thirty- 



THE NORMAL INFANT 223 

two permanent teeth, four incisors, two canines, four bi- 
cuspids and six molars in each jaw. The first four teeth 
appear at about the sixth year back of and next to the 
second molars of the milk teeth; they are called the six- 
year molars. In the seventh or eighth year the temporary 
incisors are replaced by the permanent ones. The tempo- 
rary molars fall out during the ninth or tenth year, and the 
bicuspids appear in the space left. In the eleventh year the 
permanent canines take the place of the temporary ones, 
and in the twelfth year the four second molars are cut. If 
the second teeth do not come in as they should, or are 
crowded out of position, an ugly deformity is liable to oc- 
cur unless the child is treated by a dentist. 

Teething a Normal Process. — Teething is not a dis- 
ease; it is a perfectly normal process. Other disturbances 
that occur while the teeth are pushing through must not 
be attributed to teething. Whenever the baby is sick, the 
cause of the trouble should be thoroughly investigated and 
the child should be taken to a doctor. Many a child has 
been allowed to suffer, and often to die, because its symp- 
toms were attributed to teething. Sometimes the child does 
exhibit various symptoms which are due to the eruption of 
the teeth and which disappear as soon as it is over. Dis- 
ordered dentition is shown by slight diarrhea, loss of appe- 
tite, feverishness, fretfulness, some eruption of the skin. 
irritability or other nervous symptoms. This is the excep- 
tion, however, rather than the rule. Lancing rarely is nec- 
essary. There is no objection to rubbing the gums slightly 
with the fingers, but they should never be rubbed with any 
hard substance, such as the finger-nail or a thimble. 

THE SHAPE AND APPEARANCE OF AN INFANT AT BIRTH. 

The trunk of an infant at birth is egg-shaped with the 
larger part below, the chest being poorly developed and the 



224 THE NOBMAL INFANT 

abdomen large and prominent. The shoulders and hips are 
narrow, their circumference at birth being less than that of 
the head. The arms are short and well rounded. The legs 
are even shorter than the arms, being little longer than the 
trunk, and are less rounded. They have the appearance of 
being crooked owing to the tendency of the infant to turn 
the feet in and thus produce a seeming bowing of the legs. 

The cord begins to dry up immediately after birth and 
after twenty-four hours a red line forms around its base. It 
then gradually separates, falling off about the fourth or 
fifth day. The stump that is left afterwards retracts within 
the navel. 

The Position Assumed by the Baby. — At birth it lies 
comparatively still but soon it begins to move its arms and 
legs continually. 

The normal position for an infant to lie in is on its 
side, with the head turned slightly, the thighs drawn up 
and the back presenting one long concavity. 

THE INFANT'S SIZE AND WEIGHT AT DIFFERENT AGES. 

The average height or length of the new-born infant 
is about nineteen inches, although the normal range is be- 
tween sixteen and twenty-two inches. The weight at birth 
is, on the average, seven pounds, but may be as low as six 
and a half or as high as ten pounds within normal limits. 
During the first week, and often for a longer period, the 
baby loses in weight. Throughout the next three weeks 
and the second month it gains about one ounce a day, and 
during the third and fourth months gains about five ounces 
a week, or three-quarters of an ounce a day. The following 
table of Griffith shows how a child should gain in height 
and weight from birth up to the sixteenth year: 



THE NORMAL INFANT 



225 



TABLE SHOWING THE BABY'S GROWTH IN HEIGHT AND 

WEIGHT. 



AGE. 


HEIGHT. 




WEIGHT. 




Birth 


19 


in. 


7 


lbs. 


9 


oz. 


i 


week 






. 7 


a 


7V2 " 


2 


weeks . 






• 7 


" 10/2 " 


3 
i 

2 


tt 

month 
months 






. 8 


tt 

ti 


2 


" \ Gained 1 oz. a day ; 7 oz. 


20>^ 
21 


in. 


f a week. 


it 


a 






3 


a 


22 


a 


i 2 y 4 


- i 




(Gained y 4 oz. a day; 5^2 
( oz. a week. 


4 


it 


23 


n 


13H 




5 


(« 


23/2 


it 


15 


" 1 


► * 


Double original weight. 
g > j Gained % oz. a day ; 4^ 
( oz. a week. 


6 


f< 


24 


n 


i6y 4 


- j 


► 


7 


a 


24^ 


tt 


i7 x A 


it -s 






8 


a 


25 


a 


1854 


it 




► Gained y 2 inch a month. 


9 


<« 


25^ 


a 


lsy 4 


tt 


„ 


.... Gained about 1 lb. a month. 


IO 


« 


26 


a 


lgy 4 


" 






ii 


H 


26^ 


n 


20^ 


it 






i 


year 


27 


n 


21^ 


it 


j 


.... Treble original weight. 


2 

3 


years 


31 

35 


a 
it 


27 
32 


" . 


.. 


Gained 4 inches a year. 


4 


<< 


37^ 


it 


36 


tt -> 


1 • 


Double original length. 

f Gained 3 inches and 4 lbs. 
( a year. 


5 


«( 


40 


tt 


40 


it 


i" 


6 
7 


<< 


43 
45 


tt 
tt 


44 
48 


it « 

ii 


;• 


f Gained 2 inches and 4 lbs. 
( a year. 


8 


(i 


47 


tt 


53 


it 


i 


f Gained 2 inches and 5 lbs. 
( a year. 


9 


<( 


49 


tt 


58 


tt 


10 

ii 


tt 


5i 
53 


tt 
tt 


64 

70 


it 
ii 


!- 


f Gained 2 inches and 6 lbs. 
{ a year. 


12 


tt 


55 


it 


79 


it 


) 




13 


tt 


57 


tt 


88 


ti 
(i 




f Gained 2 inches and about 
( 9 lbs. a year. 


14 
15 


ti 


59 
61 


tt 


100 
109 


tt 


" 


16 


ii 


63 


it 


117 


tt 


) 





The systematic and frequent weighing of infants during 
the first year of their lives is considered by Rotch to be of 
great importance, and far more useful as a means for ascer- 
taining their nutritive condition than any other one method 
known. The weighing of the baby determines whether the 
food is sufficiently nourishing in quality, or great enough 

15 



226 THE NORMAL INFANT 

in quantity. The first symptom of oncoming disease, es- 
pecially of a chronic form, is loss of weight. The child 
should be naked when weighed or always have on clothes of 
the same weight. The same pair of scales should be em- 
ployed at each weighing. It is advisable to weigh the baby 
at a stated interval after a feeding, as an infant is always 
heavier after eating. 

THE BOWEL MOVEMENTS OF A BABY. 

The bowels of a new-born infant generally move once 
or twice during the first day of life. For the first two or 
three days, until the child begins to nurse well, the passage 
consists of a thick, sticky, odorless, black or greenish black 
substance, called meconium. It then becomes of a golden 
yellow color, which sometimes changes upon exposure to 
the air to a greenish yellow, and shows a large proportion 
of water. It has very little odor and frequently contains 
small masses of undigested milk. For the first six weeks 
the bowels move two to four times in every twenty-four 
hours. From this age to that of two years there are us- 
ually but one to three movements daily, the passage being 
of greater consistency and a little darker in color and hav- 
ing a rather more fetid odor. If the soiled diaper is allowed 
to be exposed to the air, the color takes on a slight greenish 
tint. After the child is two years of age and is on a varied 
diet the passages become completely formed, with a dis- 
tinctive fetid odor. 

THE BABY'S URINATION. 

The urine of a healthy infant is generally like water 
in appearance, has very little odor and does not stain the 
diaper. The baby urinates about six to ten times a day, 
the frequency varying greatly in different children and 
under different circumstances. As the baby gets older, the 
frequency diminishes to about six times a day or less. 



THE NOEMAL INFANT 227 

Other Functions of the Baby. — These functions vary as 
to the time of their development. The average infant usu- 
ally cries as soon as it is born, and during the first year of its 
life expresses its distress and desires by crying. It seldom 
cries without some reason, although the cause may be trivial. 

A baby may smile to show its pleasure by the time it 
is a month old, but it does not laugh until five or six months 
of age. Its hearing is established very soon, but it usually 
does not recognize objects before the sixth or eighth week. 
By the time it is three months old, or sometimes a little 
while before, it begins to make efforts at grasping after 
objects. 

The baby is able to lift its head a little before the age 
of two months and by the time it is three or four months 
old can hold it up without support. It is not able to sit up 
unsupported until at least six months of age, but may be- 
gin to attempt to sit up between the ages of three and four 
months. By the seventh or eighth month the child begins 
to creep about on its hands and knees. It sometimes makes 
efforts to stand when it is six months old, and by the time 
it is nine or ten months of age is often able to stand with- 
out support and frequently to walk a few steps by holding 
on to the furniture or to someone's hand. By the time it 
is a year old, a strong child can walk a little without help, 
but fifteen or eighteen months is early enough for this ac- 
complishment. 

As the child grows older it begins to imitate sounds. 
By the age of eight or nine months it may utter several 
syllables intelligently, and when a year old can often say 
a few words, such as "papa" and "mamma." When eighteen 
months of age it can usually express itself by the use of a 
few words aided by gestures, and by the end of the second 
year it can usually speak in short sentences. 



CHAPTER XXIV. 

THE FEEDING OF INFANTS. 

BREAST FEEDING. 

Mother's milk the best food for a baby. The baby's thirst Composition of 
human milk. How to modify breast milk. Conditions affecting the milk. 
Rules for Nursing the Baby. Feeding during the first few days of life; 
Regularity in feeding; Frequency of feeding; How long to nurse; How the 
baby should be held. Mixed feeding. The Wet-Nurse; Choice of the wet- 
nurse. Weaning the child; Indications for weaning in the child, in the 
mother. Methods of weaning. The time for weaning. 

"Suck, baby, suck! mother's love grows by giving; 
Drain the sweet founts that only thrive by wasting." 

— Lamb, 

^plHERE are two methods of feeding an infant — by the 
^y breast and by the bottle. The best food for a baby 
^81i unquestionably is its mother's milk. 

The stomach of a new-born babe is sufficiently 
developed to digest the human milk nature intended for it, 
but is unequal to the task of digesting cow's milk. The for- 
tunate child that is nursed by its mother is much less liable 
to be attacked by disease than is a bottle-fed baby, and is 
to a certain extent exempt from digestive disturbances. 

Nursing doubtless is the greatest inconvenience of 
motherhood, and its demands are most exacting; it neces- 
sitates a woman's being with her baby at stated hours 
throughout the day and night, thus seriously interfering 
with her work or pleasure. But this self-sacrifice a mother 
owes to her baby. If she bring a child into the world, she 
must be willing to provide it with the best nourishment. 

228 



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THE FEEDING OF INFANTS 229 

This is the child's right. The greatest infant mortality is 
always among the bottle-fed babies. 

Not every mother, however, is able to nurse her child, 
as her milk may not be sufficient or of a quality suited to 
the baby's needs. Measures must be taken in the first case 
to increase the quantity of the milk and in the second to in- 
crease those ingredients which the baby needs and decrease 
those that are harmful to it. 

There are times, however, when a mother cannot nurse 
her child at all. Under such circumstances, whenever pos- 
sible, the baby should still be given human milk, through 
the employment of a wet-nurse. When the child is unable 
to be fed on human milk, it must be given some substitute. 

It is impossible to so modify the milk of an animal as 
to make it identical, chemically or otherwise, with human 
milk; yet cow's milk may be modified so that it resembles as 
nearly as possible the milk of the mother. 

The subject of breast-feeding will be considered in this 
chapter. Normal lactation will be described, with the meas- 
ures to be observed by the mother in order to alter the 
milk should it not be of the proper quality. The time for 
feeding at the different ages, the position of the child while 
sucking, and all matters pertaining to nursing will be care- 
fully detailed. Attention will then be given, in a second 
chapter, to the bottle-fed baby; the methods for artificially 
preparing milk will be taken up, with the various modifi- 
cations. 

The Baby's Thirst.— Too many mothers forget that 
the baby gets thirsty as well as hungry. The baby should 
have plenty of water during the day. The water of cities 
should be boiled and then cooled before it is given to the 
baby. An infant should be given water several times a 
day from a teaspoon, from a glass or from a nursing-bottle. 
When babies cry it often is because their little throats arc 



230 



THE FEEDING OF INFANTS 



parched with thirst. Because the child stops crying when 
given the breast does not signify that it is hungry; the 
milk may have relieved its thirst. 

Before taking up the feeding of the baby with its 
mother's milk, it is well first to state of what this milk con- 
sists, how it is altered by conditions affecting the mother, 
and how it maybe modified to suit the child's needs. 

COMPOSITION OF HUMAN MILK. 

For the first few days after the 
child is born, the breasts contain a 
thin, yellowish, sticky fluid, called 
colostrum, looking like poorly-devel- 
oped milk, but differing radically from 
that which flows later. It is not until 
about the third day after confinement 
that the secretion of milk becomes well 
established. 

Milk is a secretion of the breasts 
or mammary glands, consisting of an 
emulsion of small fat droplets, con- 
taining proteids, sugar and salts, held 
in solution. The percentage of fat in 
human milk varies between three and 
four and one-half per centum. The 
quantity of proteid, by which is meant 
that part of milk which enters into the 
composition of casein or cheese, is 
about one and one-half per centum. About six and one-half 
per centum of sugar is present. These are the normal pro- 
portions.^ Any one of the three ingredients may be increased 
or diminished in quantity, often with deleterious effect upon 
the baby's health. 

From about sixteen to fifty ounces of milk are secreted 




The Breast Cut in 
Half. Showing the struc- 
ture of the mammary gland 
with the milk ducts all 
converging at the nipple. 



THE FEEDING OF INFANTS 231 

daily by the mother's breasts ; as much as sixty-five ounces 
a day has been known. The average child, however, re- 
quires but from eight to sixteen ounces of milk during the 
first weeks of life, and from thirty to fifty ounces only be- 
tween the tenth and twelfth months. 

The composition of the milk varies somewhat during 
the act of nursing. The first milk the child sucks is known 
as the "fore-milk/' which is richest in fat and contains least 
water. During the first week of. lactation the milk usually 
is richer in proteid and poorer in fat and sugar than it is 
later. The sugar reaches its normal percentage during the 
next week or two. The increase of fat is more gradual 
and continues until the second month when it reaches its 
normal amount. As the fat increases, the percentage of 
proteid falls. So long as lactation is normal the milk will 
vary but little until the last months of nursing when, 
although the total quantity of milk secreted increases,* the 
percentage of both proteid and fat becomes less. 

HOW TO MODIFY BREAST MILK. 

The quantity of the mother's milk may be increased 
to a limited extent by increasing the amount of liquid the 
mother takes. If her supply of milk be insufficient, she 
should drink large quantities of water, tea, coffee, cocoa 
or cow's milk. She may use any of the various milk foods, 
she may take plenty of soup, and she may drink malted 
liquor in some form or one of the thinner extracts of malt. 

The quantity can be diminished by lessening the amount 
of fluids taken, by the use of purgatives, which draw the 
water from the blood, or by the administration of certain 
drugs which lessen the activity of the mammary glands. 
These measures, however, merely increase or decrease the 
water in the milk without affecting its nourishing qualities. 

Modifying the Quality.— The fat in the milk is in- 



832 THE FEEDING OF INFANTS 

creased by increasing the proportion of meat in the mother's 
diet. The eating of fat has no effect. 

The amount of fat is diminished by lessening the pro- 
portion of meat. 

The proteid becomes increased when the child is put 
to the breast too often and when the mother exercises 
too little. 

It can be diminished by prolonging the intervals be- 
tween the nursing, and by increasing the mother's exercise 
up to the limit of fatigue. 

Conditions Affecting the Milk. — It is a mistaken no- 
tion that various substances must be avoided because they 
will alter the milk, and thus will give the baby colic. It 
is only when they disturb the mother's digestion that they 
cause indigestion in the child. It sometimes happens, how- 
ever, though rarely, that raw fruit or substances contain- 
ing much acid, when eaten by the mother without affecting 
her digestion at all, may in some way alter her milk and 
disagree with the baby. 

Most mothers, if their digestion is good, can eat nearly 
everything without fear of it affecting the infant. There 
are certain drugs, however, especially some of the purges, 
which, when taken by the mother, enter her milk and affect 
the baby. But, as a rule, most mothers can be free from 
all anxiety on this point. Large quantities of alcoholic 
stimulants, if taken by the mother, may do the baby con- 
siderable harm. 

Menstruation does not always change the character of 
a woman's milk. The child may experience a slight diges- 
tive disorder, lasting two or three days, during the first and 
sometimes also during the second period after child-birth, 
but after this the infant feels the disturbance little or not 
at all. In some cases, however, indigestion occurs each 
month for a few days during the mother's monthly period. 



THE FEEDING OF INFANTS 233 

The Life of a Nursing Mother. — The mental and phys- 
ical condition of the mother influences the milk. The regu- 
lations to be followed by a woman who nurses her baby 
have been described in Chapter XXII. 

RULES FOR NURSING THE BABY. 

Feeding During the First Few Days of Life. — When 
the child has been washed and dressed after birth it should 
be put to the breast as soon as the mother has been washed 
and dressed and feels sufficiently rested to permit it — 
in about eight hours. 

As soon as the healthy child is applied to the breast 
it usually will instinctively suckle. It may be necessary, 
however, to first moisten the nipple with sugar and water 
or with milk squeezed from the breast. At first the infant 
will obtain the thin, yellowish, sticky colostrum, which, 
besides being nourishing, has a somewhat purgative action 
on the child's bowels. The early sucking of the child both 
stimulates the secretion of milk and draws out the nipples 
into good shape for nursing. 

It is a mistake to feed the child with sweetened water, 
gruel or other indigestible substance during the first day 
or two of life. Not only is this totally unnecessary, but 
it is often harmful. The child will usually be satisfied with a 
little moderately hot water, or, if it really seems ravenously 
hungry — sucking at the nipple voraciously and crying per- 
sistently, it may be given a very little modified cow's milk 
prepared as described in the following chapter. 

Regularity in Feeding. — The importance of regularity 
in nursing cannot be overestimated. There is nothing so 
ruinous to the baby's digestion and training and to the 
mother's comfort and peace of mind as that pernicious, 
though common, habit of suckling the child every time it 
cries, simply for the sake of quieting it. The mother thinks 
the child is hungry when it cries, although often, instead, 



234 THE FEEDING OF INFANTS 

it is suffering from indigestion brought on by irregularity 
in feeding. The milk may quiet it for a time but only 
increases the indigestion, frequently giving rise to even 
worse colic. Hot water may be given the baby at any time 
and will often cause the crying to cease. 

This irregularity in feeding not only upsets the child's 
digestion but it has an unfavorable influence on the char- 
acter of the milk, often making what has been good milk 
unfit for use. 

It has already been shown how the different constitu- 
ents of the milk are increased and diminished by too fre- 
quent nursing and too long intervals between nursing. 
Infants are readily made creatures of habit and by being 
fed at stated intervals can be so trained that they will show 
signs of hunger only at the time of the accustomed feeding. 
They should never be allowed to go to sleep at the breast 
with the nipple in the mouth but should either be kept 
awake until they have finished or else be removed entirely 
from the breast. When the hour for nursing arrives the 
child must be fed and if asleep should be aroused for that 
purpose. 

Care of the Baby's Mouth After Feeding. — After each 
feeding the baby's mouth should be washed out with a soft 
rag dipped in a solution of boracic acid in the proportion of 
10 grains to the ounce of water. 

Frequency of Feeding. — For the first two days of its life 
the infant may be put to the breast from four to six times 
in the twenty-four hours. During the day the baby should 
be nursed regularly every two hours in the first five weeks, 
every two and a half hours from the sixth to the twelfth 
week, every three hours from the third to the ninth month, 
and every three and a half hours from the ninth to the 
twelfth month. At night the baby may be nursed once or 
twice during the first week but after that time until the fifth 



T±tlfi FJBJSJJINC* OF INFANTS 5335 

month it should be nursed only once, at ten o'clock. After 
the fifth month it is not to be fed at all during the night. 

How Long to Nurse. — The duration of each nursing 
should not exceed fifteen minutes. If there is plenty of 
milk, one breast, as a rule, is sufficient for one nursing and 
will be emptied within that time. If there is not enough 
milk in one breast, the child should be suckled from both 
breasts at each nursing. 

At birth the baby's stomach holds only about one ounce 
or two tablespoonfuls. The baby at first sucks more milk 
than it can digest, regurgitating the excess. This vomiting 
of the baby is merely a wise provision of nature, preventing 
overfeeding; it need cause little anxiety unless accompanied 
by a very sour odor and a condition of apparent ill-health. 
If the baby seems to eat too much it should not be allowed 
to nurse quite so long. 

When the baby is unable to use all the milk, a hard 
distension of the breasts may result, described as "cake- 
breast" or "milk-cake," which should be treated as described 
in chapter XXII, on "The Care of the Mother After 
Labor." 

HOW THE BABY SHOULD BE HELD. 

The child should lie on its side, with the head supported 
by the mother's arm. While the mother is confined to her 
bed she should lie upon the same side as the breast from 
which the child is nursing, or she may be slightly propped up 
in bed with a pillow. After convalescence she leans a little 
forward while nursing, so -that the nipple drops into the 
baby's mouth. With the first two fingers of the free hand 
she should slightly steady and elevate the breast to keep 
the weight from pressing on the child's nose. She should 
withdraw the nipple now and then if the child sucks too 
rapidly, to prevent its choking and to allow it to breathe. 
She presses the breast when the milk does not come easily; 



238 THE FEEDING OF INFANTS 

or if it flows too freely of itself, she restrains it by com- 
pressing the bases of the nipple between the fingers and 
the thumb. 

When the mother's nipples are of a shape unsuitable 
for nursing, a shield or artificial nipple will have to be used. 

Often it is necessary to give modified cow's milk in 
addition to mother's milk. This occurs when the mother's 
milk is deficient in quality or in some of its constituents, 
as shown by the infant failing to gain steadily in weight. 
When such a condition arises, it is well to lengthen the in- 
tervals between breast feedings and to introduce a bottle 
of modified milk between them. In this way two, three or 
four bottles may be given daily. 

THE WET-NURSE. 

As has been said, some mothers are unwilling to nurse 
their infants. Other mothers, who would gladly suckle their 
children, have no milk at all or but a little and that only dur- 
ing the first weeks after child-birth. Sometimes after flow- 
ing freely for several months the milk may suddenly stop. 

In such cases and when owing to the mother's death the 
infant is deprived of its natural food, instead of weaning the 
baby it is much better to employ a wet-nurse. There are 
many advantages and also some disadvantages in this pro- 
cedure. 

Human milk, being the child's natural food, is greatly to 
be preferred to any substitute. Besides there is always a risk 
in feeding the child on cow's milk or the prepared foods. 
Often the employment of a wet-nurse is the baby's only 
chance for life. 

It is very difficult, however, to obtain a suitable wet- 
nurse. Knowing this, the woman is likely to become tyran- 
nical, lazy, shiftless and unreliable. She often will not take 
the proper care of herself necessary to preserve the quality 






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THE FEEDING OF INFANTS 237 

of her milk, and at any moment may become dissatisfied 
with her position and abandon it. She may, moreover, 
transmit a hidden disease to her nursling. 

The Choice of the Wet-Nurse. — This is a most im- 
portant matter and, as a rule, should be left to the attend- 
ing physician. The wet-nurse must be perfectly healthy, 
strong and not too fat. She should have no symptoms of tu- 
berculosis, syphilis or other communicable disease. If her 
own baby be healthy, it will be a possible indication as to 
her own health and as to the nutrient value of her milk. She 
should preferably be between twenty and thirty years of age 
and should have a baby approximately the same age as the 
one which she is to nurse. 

The nurse's breasts should be firm or only slightly pen- 
dulous, becoming more flabby when emptied. They should 
contain plenty of milk, allowing some milk to be pressed 
from them after the child is done nursing. The nipples 
should project well and be free from deformity, disease or 
cracks. The wet-nurse should suckle only her foster child. 

The personal qualities of the wet-nurse should be taken 
into consideration. She should be even-tempered, amiable, 
temperate and reliable. If accustomed to giving way to 
violent emotions, she may render her milk unfitted for the 
child, producing colic, diarrhea, convulsions and even more 
serious results. If addicted to the use of liquor, she may 
injure the child while intoxicated, and if she be unreliable 
or irresponsible in any way, she may neglect the child, give 
it cow's milk, or allow it to suffer harm in other ways. 

J. P. Crozer Griffith says: "A married woman is to 
be preferred, but the difficulties connected with obtaining 
a good wet-nurse are so great, and married wet-nurses often 
so scarce, that it is folly not to engage an unmarried one 
if she is qualified in other respects. Because a woman has 
made one false step does not prove her wholly bad. We 



838 THE FEEDING OF INFANTS 

must remember that we are not seeking examples of mor- 
ality, or instituting rewards for virtue or punishment for 
crime, but are simply trying to obtain a suitable manu- 
facturer of human milk where the child would suffer with- 
out. This remark applies, however, only as regards the 
first illegitimate child. A woman who has had more than 
one child illegitimately will probably be depraved in other 
respects and be unfit to be trusted. It is only through the 
danger of neglect, however, that the moral vices of a wet- 
nurse affect her foster child. There is no more probability 
of a baby imbibing the character of the nurse through the 
milk which she gives, much as we hear this talked about, 
than there is danger of a child learning to 'moo' because it 
is fed on cow's milk." 

The wet-nurse should regulate her diet and her method 
of living in general according to the rules laid down for 
nursing mothers. She must be willing to eat, exercise and 
live so as to best fit her for nursing the child. 

The baby's mother, however, should always supervise 
the wet-nurse in her management of the baby, no matter 
how trustworthy she may appear to be. 

WEANING THE CHILD. 

There comes a time when the baby must be weaned. 
The child gets to be too old to nurse at the breast, or it 
may be insufficiently nourished. The mother, moreover, 
may find nursing too irksome or injurious to her health; 
or for some other reason she may be unable to suckle the 
child. Where the employment of a wet-nurse is impossible 
or undesirable, the question of weaning the child must be 
considered. 

Indications for Weaning the Child. — When the baby 
arrives at the age of ten or twelve months it should be 
weaned, the exact age depending upon circumstances. It 



THE FEEDING OF INFANTS 2S9 

may nurse until it is a year old if it continue in the very 
best condition and the mother remain perfectly strong. As 
a rule, however, its health becomes impaired if it nurses 
longer on the breast milk, which by this time has become 
thin and poor. 

If an infant does not grow properly, although perfectly 
healthy in every other way, if it tugs long and tenaciously 
at the breast, if it is unwilling to cease suckling after it 
should have finished, or if, after nursing for a considerable 
period, it drops the nipple with a dissatisfied cry, it very 
likely is receiving insufficient milk. When in the presence 
of any of these conditions, the various methods of modify- 
ing the milk already described and the adoption of mixed 
feeding have failed to increase the quantity of the milk, 
the child should be weaned. 

Indications for Weaning in the Condition of the 
Mother. — Conditions in the mother may necessitate wean- 
ing. The nursing may render her life very much confined, 
may drain her system to a considerable extent and, in some 
instances, may injure her health. When the mother is ill, 
when her milk disagrees with the child, or when she be- 
comes pregnant again, she must cease nursing the child. 
If her milk be rendered unfit for the child with the return 
of the menstrual period, as sometimes occurs, she must 
wean the child; otherwise and as a rule this is not necessary. 

Methods of Weaning. — Whenever possible weaning is 
best done gradually. It is much better to accustom infants 
gradually to other food by means of mixed feeding than 
to take the mother's milk away suddenly. At first, the 
bottle may be substituted for the breast at but one of the 
feedings; but as time goes on, the number of bottles given 
daily instead of the breast is gradually increased. Then, 
in about a month's time, the child will be taking the bottle 
to the exclusion of the breast. In this way the child's 



240 THE FEEDING OF INFANTS 

digestive system becomes gradually accustomed to the 
new diet. 

The milk mixture in the bottle will be prepared accord- 
ing to methods described in the following chapter. In the 
latter months of infancy, however, it may be advisable to 
givQ full cow's milk, and the baby may be taught to drink 
from a glass or spoon, instead of from the bottle. 

There are times when it is necessary to wean rapidly, 
as, for example, when the mother dies, or becomes sick, 
or suddenly loses her milk. Sometimes the baby refuses 
to take the bottle at all. The only way to wean a baby 
who, despite all efforts on the part of the mother, still 
refuses to take the bottle, is to withdraw it from the breast 
entirely and at once. If it gets nothing at all to eat except 
the bottle the child is finally forced by hunger to take it. 

The mother needs to be looked after at the time of 
weaning, as well as the child, for she frequently suffers at 
this time from distended breasts. She should reduce the 
amount of liquids taken, whether water, tea, soup or milk, 
and she should take a gentle purgative. The breasts should 
be supported by one of the binders previously described, 
and when distended should occasionally be partially emp- 
tied with a breast pump. 

The Time for Weaning. — The best age for weaning 
under ordinary circumstances is at ten or eleven months, 
the exact age depending upon circumstances. " A few months 
earlier or later will not make very much difference. 

The child should be weaned between the periods of 
dentition rather than when it is cutting its teeth. 

The time of year is important. Weaning during the 
summer months should be avoided as much as possible. 
If the baby should reach its tenth or eleventh month dur- 
ing the hot weather it had better be weaned in the Spring or 
in the following Autumn. 



CHAPTER XXV. 

THE FEEDING OF INFANTS— Continued. 
ARTIFICIAL FEEDING. 

High mortality due to artificial feeding. Difficulty of providing a proper sub- 
stitute for human milk. Substitutes for mother's milk. Composition of 
cow's milk. Modified cow's milk. The percentage modification of cow's 
milk. Milk laboratories. Home modification of cow's milk. Care and 
selection of the ingredients. Preparation of the baby's food. Steriliza- 
tion and pasteurization. Mixtures for average infants at different ages. 
Frequency of feeding. Selection of bottle and nipple. Heating the Food. 
How to give the child the bottle. Care of the bottles and nipples. Pep- 
tonized milk. Condensed milk. Patent and proprietary foods. The feed- 
ing of older children. 

"And he sucks his blessed bottle till it's drier than a bone — 
Like his dad, 'e likes 'is bottle ! — and 'e's all our very own." 

— Spurr. 



HIGH MORTALITY DUE TO ARTIFICIAL FEEDING. 

HE infant who from birth has to be fed on the bottle 
is most unfortunate. There is nothing that can 
take the place of human milk. The high mortality 
of infants, especially in the summer time, usually 



results from artificial feeding. The fact that a baby is 
usually weaned after it is a year old is what makes its second 
summer such a proverbially dangerous period. The various 
digestive disturbances to which infants are so liable are due 
in the great majority of cases to improper methods of feed- 
ing and to experiments made for the purpose of determin- 
ing what food is best for the baby. A uniform and definite 

method of feeding must be adopted from the first. 
1 6 241 



242 THE FEEDING OF INFANTS 

The most perplexing problem in a doctor's experience 
is that of providing a proper substitute for the mother's 
milk. 

THE DIFFICULTY OF PROVIDING A PROPER SUBSTITUTE FOR 

HUMAN MILK. 

There is no animal whose milk is exactly like that of 
the nursing woman. By modifying cow's milk we_may 
make a mixture which will resemble human milk in its 
chemical composition, but not in its action on the baby. 
The individuality of the child is always a factor. What 
will nourish one may utterly disagree with another of the 
same age. Some babies can thrive on nearly anything; 
others have to be given food especially adapted to them. 
The artificial feeding of infants, consequently, instead 
of being a simple matter, becomes very complex. Of the 
different proprietary infant foods on the market, one will 
agree with some children and not with others. None of them 
is perfectly adapted to a baby's needs, and many are even 
harmful. 

SUBSTITUTES FOR MOTHER'S MILK. 

Of the domestic animals, the milk both of the ass and 
of the mare most nearly resembles human milk, but it can 
rarely be obtained and is apt to be very expensive. Goafs 
milk is more like that of the cow and has little advantage 
over it. The milk of the cow is the most easily procured, 
but in its natural state is unsuited to the baby's digestion. 
Therefore, before it can be given to the baby, it must be 
modified to resemble human milk by a method which will 
be described later. Whey is sometimes used as a food for 
infants. In only the rarest cases can condensed milk be em- 
ployed. There are various prepared foods which may agree 
with certain babies. Finally, one of the various proprietary 



THE FEEDING OF INFANTS 243 

foods in the market may be found just suited to an indi- 
vidual case. 

THE COMPOSITION OF COWS MILK. 

Cow's milk differs in composition from human milk. 
Although having the same amount of fat, it contains much 
more proteid (4 per cent.) and less sugar (4K per cent.). 
Cow's milk, moreover, is acid in reaction, while human milk 
is alkaline. The proteid in the cow's milk contains a great 
deal more casein, or cheese, than does human milk, causing 
the formation in cow's milk of large, thick, tough and firm 
curds, which are much less digestible than the fine, loose, 
small, floculent curds of human milk. Diluting cow's milk 
with water lessens the density and size of the curds. 

MODIFIED COW'S MILK. 

Cow's milk may be modified so as to resemble human 
milk. By diluting it with three times the amount of water 
the percentage of proteids is lowered from four to one, cor- 
responding to that of human milk. This dilution, however, 
while making the proteid more digestible, lessens the per- 
centage of all the other ingredients of the milk. The 
amount of sugar and fat is reduced to a point much below 
that required by the child. The deficiency in fat is made 
up by the addition of cream, which contains sixteen to 
twenty per centum of fat; that in sugar by the addition of 
sugar of milk, which, being an actual ingredient of milk, 
suits the child's digestion better than ordinary sugar or 
cane sugar. The reaction may be changed from acid to 
alkaline by the addition of lime-water or bicarbonate 
of soda. 

In the process of milking, transferring the milk from 
one can to another, and transporting it, the milk becomes 
contaminated with bacteria or germs which cause disease or 
digestive disorders. These germs may be killed by heating 



^44 THB FEEDIHQ OE INFANTS 

the milk by boiling or steaming. These processes are 
known as sterilization and pasteurization. 

Modified Cow's Milk the Best Substitute for Human 
Milk.— Experience has shown that cow's milk, diluted with 
water and strengthened with cream and sugar and rendered 
alkaline with lime-water, agrees with delicate infants better 
than anything else. 

The following formula makes a milk mixture resem- 
bling as closely as possible the chemical composition of 
human milk: 

Milk I ounce. 

Cream, skimmed (containing 16 per cent, fat) .. 2 ounces. 

Or 

Cream, centrifugal (containing 20 per cent, fat) 1^2 ounces. 

Lime-water y* ounce. 

Milk-sugar y 2 ounce. 

Water sufficient to make 8 ounces. 

But the fact that this mixture resembles human milk in 
its chemical composition, does not mean that it will neces- 
sarily agree with every child. 

Some of the ingredients of cow's milk, as has been 
show r n, are quite different from those of human milk. A 
newborn infant, for instance, cannot digest more than half 
of one per cent, of the proteid of cow's milk and may not 
even be able to digest that amount. 

THE PERCENTAGE MODIFICATION OF COW'S MILK. 

Importance of Percentage Feeding. — Children vary in 
their ability to digest the different constituents of the milk. 
One, as has just been said, may be unable to digest even 
one per cent, of proteids. Another may have difficulty in 
digesting fats. Especially is this true when the child is 
suffering from any digestive disorder. The percentage of 



THE FEEDING OF INFANTS 245 

each ingredient, therefore, should be modified to suit the 
need of the individual child. This modification can be 
made only by the physician, and best by one who has de- 
voted some study to the subject of infant feeding. 

Milk Laboratories.* — In many of the larger cities milk 
laboratories have been established, where infants' food is 
prepared accurately, with absolutely clean materials, ac- 
cording to the physician's prescription. The milk sold 
comes from special herds of healthy cows, and both ani- 
mals and milk are so carefully handled that perfect clean- 
liness and purity are insured. The physician writes a pre- 
scription stating the percentage of fat, proteid and sugar 
desired. The bottles are then prepared by educated, in- 
telligent men with the same accuracy that is observed by 
a pharmacist in compounding a prescription for medicine. 
Another advantage of the laboratory is that the strength 
of each ingredient is definitely known. Centrifugal cream 
or tested gravity cream and fat-free milk are employed. 

HOME MODIFICATION OF COW'S MILK. 

Milk laboratories exist only in some of the larger cities. 
Where they are not available and where their services can- 
not be afforded, the milk must be modified at home. Under 
these circumstances percentage feeding can still be carried 
on, the physician telling the mother the exact quantities of 
cream, milk and sugar to use in preparing the bottles. 

Realizing that a physician may not always be avail- 
able or may not be familiar with percentage feeding, the 
author will describe the method of preparing artificial food 
for the average child. It cannot be too strongly emphasized, 
however, that should the child not thrive, as evidenced by 
continuous loss of weight, or should it develop vomiting or 
diarrhea, a physician must be consulted without delay. 



246 THE FEEDING OF INFANTS 

It is not always possible to get a good quality of cow's 
milk. Absolute cleanliness is necessary at dairy and shop. 

CARE AND SELECTION OF THE INGREDIENTS. 

The cow should be milked in a perfectly clean place 
bv one who wears fresh, clean clothes, and whose hands 
have been thoroughly washed and dried with a clean 
towel. The udders of the cow and the milk pails should 
be scrupulously clean. The milk should not stand around 
the barn, but should be cooled rapidly and at once sealed 
in jars. In some cities certificates are issued to dairies 
which are especially careful about such matters. If milk 
be suspected, it should be sent to be analyzed by a chemist 
or by the State or municipal milk inspector; otherwise it is 
impossible to tell whether the milk has been watered, arti- 
tificially colored, or mixed with some preservative. 

It is necessary to know the percentage of fat in the 
cream used. The cream usually purchased contains sixteen 
per cent. fat. The formulas given in this chapter, conse- 
quently, will be based on a cream of that richness. It 
would be well in ordering cream to state the percentage of 
fat desired. 

The milk should be skimmed before being used. 

Only boiled water should be employed. 

The sugar used should be the commercial milk-sugar 
bought at the stores. If ordinary granulated sugar or cane 
sugar — which is much less desirable — be employed, it should 
be used in about half the amount given for milk-sugar. 

THE PREPARATION OF THE BABY'S FOOD. 

All the bottles of modified milk required for the twenty- 
four hours are usually prepared at the same time. 

The amount of the various ingredients and the size and 
number of the bottles required for infants at different ages 
are given later in this chapter. 



THJfl FEEDING OF INFANTS 247 

On the arrival of the milk and cream in the morning 
the requisite amounts should at once be measured out and 
mixed with the water, in which the milk-sugar should first 
be dissolved. The lime-water or soda solution is then added 
unless the bottles are to be sterilized. The soda solution is 
made by dissolving a teaspoonful of bicarbonate of soda in a 
quart of water. If the bottles are to be sterilized, the lime- 
water must be added to each bottle just before it is given to 
the baby, as a peculiar chemical reaction occurs when sugar 
and lime-water are boiled together. As the soda solution is 
not affected by boiling, it can be added before sterilization. 

The bottles, having been cleansed in the manner de- 
scribed on page 253, are then filled, each with as much of the 
mixture as will be required for one feeding. The mouths of 
the bottles are then carefully dried and plugged with raw 
absorbent cotton-wool. 

If the milk and cream are uncontaminated, owing to 
the great precautions taken to guard them, the mixture need 
not be sterilized or pasteurized, but may at once be put upon 
the ice. This is the preferable method, as heating injures 
the nutritive value of the milk. 

As a rule, however, milk contains large numbers of in- 
jurious bacteria which must be killed by sterilization or 
pasteurization before the milk is given to a baby. This is 
the safest plan, being usually more necessary in hot weather, 
but especially in the presence of digestive disturbances. 

STERILIZATION AND PASTEURIZATION. 

Milk is sterilized when it has been subjected for at least 
ten minutes to the boiling temperature, 212 F. In pasteuri- 
zation the milk is heated to 155 F. This latter temperature 
is sufficient to kill any harmful germs, while at the same 
time it does not injure the digestive qualities of the milk 
nor does it affect the taste. 



248 THE FEEDING OF INFANTS 

Sterilization. — The milk may be sterilized before or 
after it is bottled. In the former case it is boiled in a vessel; 
in the latter, the bottles may be placed in boiling water or 
steamed in a farina kettle, but usually a special apparatus 
is employed. 




CandF 



The Arnold Steam Sterilizer. 

The Arnold steam sterilizing apparatus (see figure) 
consists of a water reservoir (A), a sterilizing chamber (B), 
a bottle rack (C), a cover (D), a hood (E), eight graduated 
bottles (F), each holding a little over seven ounces, and a 
brush (G). 

As soon as the bottles are stoppered they are placed in 
the bottle rack, which is then inserted in the sterilizing 
chamber, and the lid and hood are applied. The pan of the 
sterilizer is filled two-thirds full with water and the whole 
apparatus is placed on the hot stove for an hour. 

A home-sterilizer may be improvised out of a tin pail 
or can. 

Pasteurization.— This is a more troublesome process 
than the one just described, unless a special apparatus, 




"2 



8 I 






1 « 



3 






^ ^ 






THE FEEDING OF INFANTS 



248 



known as the Freeman pasteurizer, be employed. This ap- 
paratus consists of a pail for water and a receptacle for the 
bottles of milk. The pail is a simple one with a cover. Ex- 
tending around the pail is a groove for indicating the level 
to which it is to be filled with water. Inside the pail are 




The Freeman Pasteurizer. 



three supports (C) for holding the receptacle. The recepta- 
cle for the bottles of milk consists of a number of hollow 
cylinders fastened together. Surrounding and binding to- 
gether the group of cylinders is a wire (A). It is this wire 
(A) which rests on the support (C) when the milk is being 
heated. Below the wire (A) are three short wires (B). 
These wires (B) rest on the supports (C) when the recepta- 
cle is raised for cooling (see figure above). 

If a thermometer be placed in one of the bottles and 
watched, so that it does not rise above 155 F., the Arnold 



35U THE FEEDING OF INFANTS 

sterilizer may be used for pasteurizing, the hood being left 
off and the lid being set ajar. An inexpensive method is to 
place the bottles of milk in a dishpan or large saucepan of 
water, having a false bottom formed by laying inside the pan 
an inverted tin pie plate with holes punched in it. This is 
heated until a thermometer placed in the water registers 
170 F., whereupon it is removed from the stove, covered 
with an old blanket and allowed to stand forty-five minutes. 

After being sterilized or pasteurized, the bottles are at 
once put under the spigot and cooled rapidly with running 
water, after which they are placed upon the ice. 



MIXTURES FOR AVERAGE INFANTS AT DIFFERENT AGES. 

The only accurate and intelligent method of preparing 
mixtures to suit the needs of infants of different ages is by 
means of percentage modification of clean, pure cow's milk. 
The percentage of each ingredient must be altered as the 
child gets older and stronger and as its digestive ability 
increases. Below are given the prescriptions for the various 
ages of infants born at term and of normal development 
and weight. With the prescription is given the method for 
preparing the bottles at home. A child should be classed 
according to its weight rather than its age. The percentages, 
however, (which are those given by Rotch) are intended 
only to be provisional. They are meant for infants who 
digest well and gain progressively in weight. They will 
have to be further modified by the physician to suit the 
needs of children suffering from digestive disorders. 

The quantities given are those required for the whole 
twenty-four hours' feeding. When but one bottle is pre- 
pared at a time, these quantities should be divided by the 
number of bottles which were to be filled with the 
mixture. 



X-tUS FEEDING OF INFANTS 251 

For the First Week of Life.— 

B Fat 2 per cent. 

Proteids 0.5 per cent. 

Milk-sugar 5 per cent. 

Alkalinity 5 per cent. 

To obtain a mixture containing these percentages, and of a quan- 
tity just sufficient to make the number of bottles required: 

Take of cream (16 per cent.) 1% ounces, milk y ounce, milk- 
sugar y 2 ounce, lime-water (or soda solution) ]/ 2 ounce, boiled water 
8 ounces. Fill 10 bottles with 1 ounce each. 

For the Second Week. — 

3 Fat 2.5 per cent. 

Proteids 0.75 per cent. 

Milk-sugar 5.5 per cent. 

Alkalinity 5 per cent. 

Take of cream (16 per cent.) 2^2 ounces, milk 1 ounce, milk- 
sugar 1^4 ounces, lime-water (or soda solution) y ounce, boiled 
water ioj4 ounces. Fill 10 bottles with \y 2 ounces each. 

The Third Week.— 

B Fat 3 per cent. 

Proteids 1 per cent. 

Milk-sugar 6 per cent. 

Alkalinity 5 per cent. 

Take of cream (16 per cent.) 3^4 ounces, milk 2% ounces, milk- 
sugar 2% ounces, lime-water (or soda solution) 1 ounce, boiled water 
13 ounces. Fill 10 bottles with 2 ounces each. 

Four to Six Weeks. — 

8 Fat 3.5 per cent. 

Proteids 1 per cent. 

Milk-sugar 6.5 per cent. 

Alkalinity 5 per cent. 

Take of cream (16 per cent.) 4j£ ounces, milk 1 ounce, milk-sugar 
1% ounces, lime-water (or soda solution) 1 ounce, boiled water 16 
ounces. Fill 9 bottles with 2I2 ounces each. 



S5S THE FEEDING OF INFANTS 

Six to Eight Weeks.— 

7% Fat 4 per cent. 

Proteids 1.25 per cent. 

Milk-sugar 7 per cent. 

Alkalinity 5 per cent. 

Take of cream (16 per cent.) 5^ ounces, milk 2 ounces, milk-sugar 
1^2 ounces, lime-water (or soda solution) 1% ounces, boiled water 
1 5% ounces. Fill 8 bottles with 3 ounces each. 

Two Months. — 

B Fat 4 per cent. 

Proteids 1.5 per cent. 

Milk-sugar 7 per cent. 

Alkalinity 5 per cent. 

Take of cream (16 per cent.) 5^ ounces, milk 4% ounces, milk- 
sugar 1 J/2 ounces, lime-water (or soda solution) ij4 ounces, boiled 
water 15 ounces. Fill 8 bottles with 3^4 ounces each. 

Three Months.— 

5 Fat 4 per cent. 

Proteids 1.5 per cent. 

Milk-sugar 7 per cent. 

Alkalinity 5 per cent. 

Take of cream (16 per cent.) 6 ounces, milk 4^ ounces, milk- 
sugar 1 J/2* ounces, lime-water (or soda solution) iy 2 ounces, boiled 
water \6y 2 ounces. Fill 7 bottles with 4 ounces each. 

Four Months. — 

B Fat .^ 4 per cent. 

Proteids 2 per cent. 

Milk-sugar 7 per cent. 

Alkalinity 5 per cent. 

Take of cream (16 per cent.) $% ounces, milk ioy 2 ounces, milk- 
sugar iy 2 ounces, lime-water (or soda solution) iy 2 ounces, boiled 
water 14J4 ounces. Fill 7 bottles with 4^ ounces each. 



THE FEEDING OF INFANTS 253 

Five Months.— 

B Fat 4 per cent. 

Proteids 2 per cent. 

Milk-sugar . 7 per cent. 

Alkalinity 5 per cent. 

Take of cream (16 per cent.) 5^ ounces, milk 11 ounces, milk- 
sugar ij4 ounces, lime-water (or soda solution) 1% ounces, boiled 
water 14^ ounces. Fill 6 bottles with 5^ ounces each. 

Six Months.— 

3 Fat 4 per cent. 

Proteids 2.5 per cent. 

Milk-sugar 7 per cent. 

Alkalinity 5 per cent. 

Take of cream (16 per cent.) 4% ounces, milk 1734 ounces, milk- 
sugar iy 2 ounces, lime-water (or soda solution) 1^4 ounces, boiled 
water iiJ4 ounces. Fill 6 bottles with sH ounces each. 

Seven Months.— 

B Fat 4 per cent. 

Proteids 2.5 per cent. 

Milk-sugar 7 per cent. 

Alkalinity 5 per cent. 

Take of cream (16 per cent.) 434 ounces, milk 18^4 ounces, milk- 
sugar 134 ounces, lime-water (or soda solution) 2 ounces, boiled water 
12 ounces. Fill 6 bottles with 6y\ ounces each. 

Eight Months. — 

3 Fat 4 per cent. 

Proteids 2.5 per cent. 

Milk-sugar 7 per cent. 

Alkalinity 5 per cent. 

Take of cream (16 per cent.) 5J4 ounces, milk 21 ounces, milk- 
sugar 2 ounces, lime-water (or soda solution) 2 ounces, boiled water 
1334 ounces. Fill 6 bottles with 7 ounces each. 



254 THE FEEDING OF INFANTS 

Nine Months,— 

ft Fat 4 per cent. 

Proteids 3 per cent. 

Milk-sugar 7 per cent. 

Alkalinity 5 per cent. 

Take of cream (16 per cent.) 3*^ ounces, milk 28 ounces, milk- 
sugar ij4 ounces, lime-water (or soda solution) 2 ounces, boiled water 
Z l / 2 ounces. Fill 6 bottles with 7 ounces each. 

Ten to Ten and One-half Months.— 

$ Fat 4 per cent. 

Proteids 3.25 per cent. 

Milk-sugar 5 per cent. 

Alkalinity 5 per cent. 

Take of cream (16 per cent.) 2^ ounces, milk 31^ ounces, milk- 
sugar 94 ounce, lime-water (or soda solution) 2 ounces, boiled water 
6 ounces. Fill 5 bottles with %y 2 ounces each. 

Ten and One-Half to Eleven Months. — 

ft Fat 4 per cent. 

Proteids 3.5 per cent. 

Milk-sugar 4.5 per cent. 

Alkalinity 5 per cent. 

Take of cream (16 per cent.) 2 ounces, milk, 35 ounces, milk-sugar 
24 ounce, lime-water (or soda solution) 2 ounces, boiled water 3^ 
ounces. Fill 5 bottles with Sy 2 ounces each. 

Babies Over Eleven Months. — Unmodified cow's milk and cereals, 
shown on page 256. 

FREQUENCY OF FEEDING. 

The number of times a baby is fed in the twenty-four 
hours depends upon its age and size. 

First Four Weeks of Life. — During the first two days 
after birth an infant is fed not oftener than four or six 



THE FEEDING OF INFANTS 255 

times in the twenty-four hours. From the second day to 
the end of the fourth week it is fed every two hours be- 
tween six in the morning and ten at night, and once during 
the night, about 4 A. M. 

Fifth and Sixth Weeks. — The baby is fed every two 
hours between seven in the morning and ten in the evening, 
and once during the night, about 3 or 4 A. M. 

Sixth Week to the End of the Third Month.— The child 
is fed every tw T o and a half hours during the day between 
six and ten, and once at night, at 3 A. M. 

Fourth and Fifth Months. — The baby is fed every two 
and a half hours during the day, but is not fed during the 
night after ten o'clock. 

Fifth Month to the End of the Ninth Month.— The 
child is fed every three hours during the day and not at all 
during the night. 

Ninth Month to One Year.— The child is fed every 
three hours, but is only given five bottles during the day 
and none at night. 

SELECTION AND CARE OF BOTTLE AND NIPPLE. 

The Bottle. — An ordinary nursing bottle, or the bottles 
that come with the pasteurizing apparatus, may be used. 
The bottle should be made smooth inside, without angles or 
depressions, so that it may be easily cleansed. 

As soon as the child has finished, the bottle must be 
taken away, emptied of any milk that may remain, rinsed 
well and placed in a strong solution of washing soda and 
water. Every evening the bottles should be removed from 
this solution and scrubbed inside with a bristle brush. In 
the morning, just before being filled, they should be boiled. 

The Nipples. — There should be at least two conical 
rubber nipples, preferably of black rubber. The hole should 
be of such a size that when the bottle is inverted the milk 



me THE FEED1MG OF infants 

drops easily from it but does not run too fast or in a stream. 
The nipple should be dipped for a moment in hot water 
before being used. The form of nipple which is attached 
to the bottle by a long rubber or glass tube should never 
be used, as it is impossible to keep the tube clean. 

The nipple should be removed from the bottle imme- 
diately after nursing, scrubbed thoroughly with a soft 
bristle brush at first outside and, after being inverted, in- 
side as well. It should then be placed in a solution con- 
taining half an ounce of boric acid to a pint of water and 
kept there until used again. Once a day all the nipples 
should be boiled for five minutes in water containing a little 
table salt. An infant should not be given a nipple to suck, 
as it may fill its stomach with wind and suffer from colic in 
consequence. 

HEATING THE BABY'S FOOD. 

When the bottle containing the modified milk has had 
the cotton plug removed and the nipple fitted on, it should 
be heated before being given to the baby. This is done by 
setting the bottle in a cup, or preferably in a small, narrow, 
cylindrical vessel, about three inches in diameter, just high 
enough to reach to the neck of the bottle, and having a 
perforated false bottom. The receptacle should contain cold 
water, which is heated until the contents of the bottle are at 
a temperature not exceeding 95 to ioo°. If the bottle is put 
directly into hot water, it is liable to crack. 

HOW TO GIVE THE CHILD THE BOTTLE. 

The baby may lie upon its back when taking the bottle, 
or it may be held in the arms as described in the preceding 
chapter. The bottle should be held by the nurse, who must 
see that the neck is always full of milk. When the nipple 
collapses, its edge should occasionally be lifted from the 
bottle to allow the air to enter. The baby should take about 



THE FEEDING OF INFANTS 257 

ten minutes or more to its bottle, with slight rests now and 
then. 

HOW TO PREPARE PEPTONIZED MILK. 

When the infant's digestive power fails, owing to ill- 
ness or other causes, the milk may have to be peptonized. 
This is done in the following manner when unmodified 
cow's milk is used: 

To four tablespoonfuls of cool, boiled water add the 
contents of one Fairchild's peptonizing tube, stirring until 
it is dissolved. Add this to one pint of cool milk and put 
the vessel containing the mixture into water of a tempera- 
ture of 115 F., where it should remain for ten minutes, or 
for a shorter time if the slightest bitter taste develops. It is 
then either put on ice at once or quickly boiled. 

When a milk-mixture is used the peptonizing powder 
is added in the proportion of one tube to each sixteen 
ounces of combined milk and cream. 

PATENT AND PROPRIETARY FOODS. 

There are a great number of these foods on the market. 
They contain too little fat and too much sugar, and often 
contain starch. They are seldom reliable. Most of them are 
unsuited to a young baby, but occasionally one may be 
used to advantage. Experimenting is dangerous ; the advice 
of an experienced physician should always be sought. 

THE RESULTS OF FEEDING WITH CONDENSED MILK. 

There are three forms of condensed milk: (1) con- 
densed unsweetened whole milk, (2) condensed sweetened 
whole milk, and (3) condensed sweetened skimmed milk. 
Of these, the second and third forms should never be used 
and the first but rarely. When diluted according to the 
directions, they contain too small a percentage of fat, less 
than one per cent. On the other hand they contain too 
much sugar. 

17 



£58 THE FEEDING OF INFANTS 

Many children are starved on condensed milk. Others 
fed on this milk may appear plump, but are usually found to 
be pale and flabby, lacking power to resist disease and being 
especially liable to develop rickets and scurvy. Once in a 
great while, however, a child will be found who thrives best 
on condensed milk. 

THE FEEDING OF OLDER BABIES. 

It is important to know what is the proper food for older 
infants. Professor Rotch, of Harvard University, feeds 
them in much the following manner : 

Eleven to Twelve Months. — At this age cereals, such as 
oats, barley and wheat, may be added to the baby's bottle in 
the form of a jelly, which is prepared as follows: Six ounces 
of oat flour (or barley flour or wheat flour) is put into one 
quart of water, and the whole is boiled for twenty minutes. 
Enough water is then added to replace what has evapo- 
rated. The mixture, while hot, is then strained through a 
thin white cloth, making a very thick jelly. 

One Year to Thirteen Months. — After it is a year old, 
the baby should be gradually accustomed to taking its food 
from a spoon. For some months still, however, a bottle 
may be given at night and before the morning nap. An 
infant of this age should have five meals during the day, 
arranged in the following manner: 

For breakfast, bread and cow's milk, slightly warmed. 

For lunch, equal parts of oat jelly and cow's milk, 
warmed, with a little salt added according to the infant's 
taste. 

In the middle of the day, broth of some kind, either 
chicken or mutton, can be given with some bread. 

To prepare the broth, a fowl weighing about three 
pounds (or a shoulder of lamb or mutton weighing from 
five to seven pounds) is boiled for two hours with two ta- 



THE FEEDING- OF INFANTS 259 

blespoonfuls of rice, two quarts of cold v/ater, and salt and 
pepper. When the fluid has boiled down to one quart it is 
strained, while hot, through a fine sieve. 

In the middle of the afternoon the rneal of oatmeal 
jelly, as given for lunch, is repeated. 

The fifth meal, given in the latter part of the after- 
noon, should consist of bread and milk. 

Fourteen to Fifteen Months.— Some thoroughly boiled 
rice may be added to the broth in the middle of the day. 

A baked apple or apple sauce or a ripe peach may be 
given at the evening meal. 

Sixteen Months.— The infant can now have a small 
amount of butter on its bread. 

Seventeen to Eighteen Months. — At the mid-day meal 
the child may have a thoroughly baked white potato mixed 
with butter and salt. 

Eighteen Months to Two Years.— Griffith suggests the 
following list as a guide to the diet of babies of this age. 
Several different menus are given, each numbered, so that 
a mother may have a choice and can so alternate them that 
the child will not tire of any : 

Breakfast, 7 A. M. — (1) A glass of milk with a slice of bread and 
butter or a soda, graham, oatmeal or similar unsweetened biscuit; or 
(2) A soft-boiled egg with bread and butter and a glass of milk ; or (3) 
Porridge made of oatmeal, arrowroot, wheaten grits, hominy grits, 
etc., or one of the numerous good breakfast foods on the market. 

Second Meal, 10 A. M. — (1) Bread broken in milk; or (2) Bread 
and butter or a soda or other biscuit with a glass of milk. 

Dinner, 2 P. M. — (1) Boiled rice or a baked potato mashed and 
moistened with dish-gravy (no fat) or beef juice made as stated later. 
a glass of milk; or (2) Mutton or chicken broth with barley or rice in 
it, some bread and butter and some sago or rice pudding made with 
milk; or (3) A small portion of minced white meat of chicken or 
turkey, or minced rare roast beef, beefsteak, lamb, mutton or fish, 
bread and butter, a glass of milk. 



160 



THE FEEDING OF INFANTS 



Fourth Meal, 5 P. M. — (1) Bread and milk; or (2) Bread and 
butter and a glass of milk. 

Fifth Meal, 9 to 10 P. M.— It is probable that no fifth meal will 
be needed, but if it is, it should consist only of milk. 

To Make Beef- Juice. — Cut into rather thin pieces and 
very slightly broil one pound of round or tenderloin steak 
free from fat. Then cut into smaller pieces and express the 
juice with a lemon-squeezer or, much better, with one of the 
meat-presses to be bought at the shops. Season with salt. 
The pound of meat will give from three to six ounces of 
beef-juice or thereabouts. After it is obtained, the juice can 

be warmed only slightly or 
it will coagulate. It may 
be given cold if desired. 
Occasionally infants prefer 
it sweetened. 

Another method recom- 
mended, when a lemon- 
squeezer or a press is not 
at hand, is the following: 
Broil one pound of beef as 
before, then chop very fine, 
place in a jar, add four 
ounces of water, stir thor- 
oughly, stand on ice for 
six or more hours. Strain 
through cheesecloth or mus- 
lin by twisting this hard. 
This method gives proba- 
bly twice as much juice as 
the first. 

Two to Three Years. — The diet at this age may be as 
follows, according to Griffith. His tables are only a guide, 
not an absolute rule, both as to the time of meals and as 




A Meat-Press. 



w 



o 



W 







\ 



A 



THE FEEDING OF INFANTS 261 

to the nature of the food; they represent the extreme of 
what a child can take rather than indicate what every child 
ought to have. 

Breakfast, 7 to 8 A. M. — (1) A small portion of beefsteak, with 
oatmeal, hominy grits, wheaten grits, cornmeal or other cereal por- 
ridge, and with plenty of milk; or (2) A soft-boiled egg, bread and butter 
and a glass of milk. 

Second Meal, 11 A. M. — (1) A glass of milk with bread and butter 
or with a soda or other biscuit; or (2) Bread and milk; or (3) Chicken 
or mutton broth. 

Dinner, 2 P. M. — Roasted fowl, mutton or beef, cut fine ; mashed 
baked potato with butter or dish-gravy on it; bread and butter. As 
dessert, tapioca, sago or rice pudding, junket or fresh or stewed fruits 
in small quantity, including raspberries, strawberries, grapes freed 
from the seeds, peaches, juice of oranges, and stewed apples. Bananas 
should not be given. Indeed, the use of orange juice or of some cooked 
fruit is often advantageous before this age, especially if there is any 
tendency to constipation. 

Supper, 6 P. M. — (1) Bread and butter; or (2) Milk with soda or 
similar biscuit, or with bread and butter. 




CHAPTER XXVI. 
BATHING THE BABY. 

The New-born Infant's First Bath. Removing the vernix caseosa. Articles 
needed for the bath. The preparation of the bath. Rules for bathing the 
baby. How to bathe an Infant. Rinsing and drying the baby. Care of 
the Hair and Scalp. Cleansing the Parts After a Bowel Movement. Bath- 
ing Older Children. Sea Bathing for Children. Care of the nose. 

"Cleanness of body was ever deemed to proceed from a due reverence 
to God." — Bacon. 

THE NEW-BORN INFANT'S FIRST BATH. 

IEMOV1NG the Vernix Caseosa.—- The new-born in- 
fant is covered with the waxy substance known as 
the vernix caseosa,. described in Chapter XXIII. 
This must be removed before the child can be 
bathed; consequently before the first bath is given the infant 
should be gently but thoroughly rubbed all over with olive 
oil or purified white vaseline or washed unsalted lard or 
white of egg. It is then bathed in the manner described 
below, after which the bow knot on the string around the 
umbilical cord is slipped and the ends are again tied tightly 
around the cord in a final permanent knot. This is done 
on account of the shrinkage the cord undergoes during the* 
first bath. 

Articles Required for the Bath.— There are certain arti- 
cles one must have at hand before beginning the baby's 
toilet. In addition to the baby's basket and its contents, 
which have been described in Chapter XIX, the following 
articles are needed for the daily bath: A tub, which may 

262 



BATHING THE BABY 263 

be made of tin, porcelain, copper, iron or rubber; a low 
stand for the tub; a china basin; a bath thermometer; a 
rubber cloth or an oil cloth, which is to be laid beneath 
the tub; a low chair with a broad seat; a rubber apron; a 
bath-apron consisting of two long and broad pieces of soft 




Thermometer for the Bath. 

white flannel sewed together above or, better still, attached 
to a waist-band, one in front of the other; a piece of good 
soap — imported castile or palm oil; two wash-rags, which 
may be made of soft flannel or of old diaper cloth; a large, 
fine, soft sponge; two large towels of some fine absorbent 
material, which should be warm and dry; and a simple 
dusting powder, such as ordinary talcum powder. 

The Preparation of the Bath. — The water in the baby's 
bath should be soft and clear. The bath tub should be 
filled to such a height that the semi-reclining baby is cov- 
ered up to the neck. For a new-born infant the temperature 
of the water should be ioo° F. When the baby has reached 
the age of six months it should be bathed in water at 
a temperature of 90 to 95 F. in the winter-time, and 
8o° to 85 F. in the summer-time. When the hardening 
effects of a cold bath are desired the temperature should 
be regulated as described in Chapter II. 

Rules for Bathing the Baby. — There must be a regular 
time for the bath. The best hour is about ten o'clock in 
the morning, midway between two feedings. The child 
should not be bathed when it is cold or overheated, or im- 
mediately after a meal. The bath should be given in the 
warmest part of the room, before a fire, if possible, and in 
a position where there is no danger from draughts. A 



264 BATHING THE BABY 

screen placed around the chair and tub may serve to keep 
away. draughts. 

How to Bathe an Infant. — The mother or nurse, wear- 
ing the rubber apron and over this the bath apron, sits 
upon the low chair with the tub in front of her. The baby 
is undressed and wrapped in the outer fold of the bath 
apron. Its face, with the exception of the ears, is then 
washed with water and a soft wash rag which must be used 
exclusively for this purpose. No soap should be used on 
the face. The mouth is cleansed by means of a little moist- 
ened absorbent cotton or a moistened square of muslin 
wrapped around the little finger or around the end of a 
smooth stick, and projecting well beyond it. When the 
teeth have been cut they should be rubbed with a moist- 
ened cloth and later with tooth powder, which may be ap- 
plied by means of a soft, fine stick sharpened into a chisel- 
shaped edge. The eyelids are separated and a little warm 
water is allowed to fall on them, or the eyes may be washed 
with a fresh piece of absorbent cotton. The ears are then 
carefully gone over with a dampened wash cloth. The 
second wash cloth being brought into service, the whole 
body, including the scalp, is bathed with soap, particular atten- 
tion being paid to the arm-pits, the groins and the parts be- 
tween the folds of the buttocks. 

Rinsing and Drying the Baby. — The nurse then picks 
up the child so that its head and back are supported by her 
left arm and hand, in which position she lowers it gently 
into the tub until it is submerged up to the neck, being 
careful not to allow the head to dip under the water. The 
child remains in the tub from one to five minutes, during 
which time it is washed and douched with the sponge. 
Sometimes after this the child is rubbed all over very 
rapidly with cold water. In many cases, however, this is 
omitted. The child is lifted into the lap and enveloped in 



BATHING THE BABY 265 

a towel or in the dry folds of the bathing apron. It is then 
patted thoroughly dry, but is not rubbed with the towel. 
The nurse, with the palm of her hand, then rubs the baby 
gently all over until the skin is slightly reddened, rubbing 
especially each side of the spine. After this it is customary, 
though not absolutely necessary, to powder the folds of 
the skin, the child being then quickly dressed. 

Care of the Hair and Scalp, — The baby's hair should 
be brushed with a camel's hair brush; no comb should ever 
be used. After the baby is six months old the scalp is not 
to be included in the general sponging oftener than twice 
a week. 

Cleansing the Parts After a Bowel Movement. — After 
each bowel movement the lower parts of the baby's body 
should be sponged with warm water, but without soap, and 
then carefully dried. When chafing occurs the parts should 
be gently cleansed with starch-water and dried with a soft, 
clean towel, after which they may be dusted with ordinary 
talcum powder or with a mixture consisting of powdered 
camphor 90 grains, powdered zinc oxide V*. ounce and 
powdered starch 1 ounce. 

BATHING OLDER CHILDREN. 

After a child is three years of age it should be given 
a sponge bath every morning. The temperature of the 
water at first may be 75 F. in the summer or 85 F. in 
the winter. It then may be gradually reduced to 6o° F. 
or to the temperature of the water as it flows from the 
faucet. The skin should be dried with a soft towel and 
afterwards rubbed with the open hand until it glows, or 
the friction may be applied by means of the towel. The 
whole process should not last longer than five or ten 
minutes. This bath is given for its hardening effects, as 
described in Chapter II. At the same time three warm, full 



286 BATHING THE BABY 

baths a week are required for cleanliness, and are given 
preferably in the evening. 

When the child grows older he learns to wash himself. 
He should take a cold sponge or plunge bath immediately 
after rising, and in addition should always take a warm 
cleansing bath once a week. The latter is best taken be- 
fore going to bed and should not occupy more than ten 
minutes; it should be followed by a cold shower or a rapid 
cold sponge. 

SEA BATHING FOR CHILDREN. 

To carry a small, terrified child into the ocean is un- 
wise as well as cruel. It is better to gradually accustom 
the child to the water. A child of three years of age or 
even younger may be dressed in a bathing suit and allowed 
to play on the beach and splash in the shallow water. An 
older child may enter the surf after wetting its head. If 
the weather be cool, ten minutes is long enough for the 
bath, although if the weather be warm, twenty to twenty- 
five minutes is not too long, provided the reaction is good. 
A child should come out of the water at once, however, at 
the first indication of chattering of the teeth or blueness 
of the lips. If the child seem exhausted or listless after 
the bath he must go into the water less frequently and 
remain for a shorter time. Under no circumstances should 
the surf bath be taken oftener than once a day. No one 
should enter the water when cold or perspiring, or until 
three hours have elapsed after a meal. 

CARE OF THE NOSE. 

It is necessary to teach a child to keep its nose clean. 
In blowing the nose it should be taught not to compress 
the nostrils and not to blow with much force, as ear trouble 
is thereby frequently produced. If the nose seems stopped 
up it may have to be sprayed with a disinfectant solution. 



CHAPTER XXVII. 

CLOTHING FOR THE INFANT AND THE 

CHILD. 



Dressing the Infant: Character of the infant's clothes; the baby's binder; the 
diapers; the infant's shirt, petticoat, dress, socks, night-clothes and other 
garments. The Baby in Short Clothes: Stockings, drawers, diaper-sup- 
porters, foot-gear, bibs, creeping-aprons, outing clothes, night slip, wrapper. 
Children's Clothing: Underwear, outer garments, shoes, clothing for out- 
of-doors, night attire. 



'On parent knees, a naked, new-born child, 
Weeping thou sat'st while all around thee smiled." 

—Jones. 



HE clothing required for the infant, for the older baby 
and for the full-grown child have so many points of 
difference that each will be treated separately. 

DRESSING THE INFANT. 

The various principles in regard to articles of apparel 
laid down in Chapter V apply to children as well as to 
adults; there is no difference in the objects for which clothes 
are worn and the conditions they must fulfill. 

Character of the Infant's Clothes. — For a baby's clothes 
wool is the best material, and all the garments that come 
next to the skin, with the exception of the diapers, should 
be made of it, the weight of course varying with the season. 
When wool cannot be worn the clothes may be made of 
merino, which contains only a small portion of wool, or of 
a machine-knitted cot I on goods known as stockingette. 
Constriction is to be avoided; the clothes must be loose and 

267 




268 CLOTHING FOR INFANT AND CHILD 

allow sufficient freedom of motion As the baby's skin is 
very delicate and easily irritated, it is necessary that the 
clothing be soft both in surface and texture. 

A list of the clothes required for an infant has been 
given in Chapter XIX on "Preparations for the Confine- 
ment. " 

The Baby's Binder. — The best form of the abdominal 
binder is a circular band of knitted wool, made, as a rule, 
with shoulder straps and with a little tab in front to be 
fastened to the diaper. Another kind consists of a strip of 
soft flannel twenty inches in length, cut bias, which is 
usually fastened to the shirt. The binder should extend 
from the hips to the lower ribs. It is used at first as a 
protection for the umbilical cord and later as a covering for 
the abdomen to prevent chilling. It must not be so tight 
that the ribs and abdomen are compressed, but should be 
loose enough for the hand to slip under it easily. 

The Diapers. — The diapers or napkins should be made 
of linen or cotton, not of canton flannel. They should never 
be covered with water-proof material. For an infant at 
birth they should be about a yard long and half a yard 
wide, but as the child gets older they have to be made 
larger. Every time it is soiled, even if only with colorless 
urine, the diaper must be changed. It should be washed 
with pure soap, without soda, and thoroughly dried before 
it is again applied. 

The Infant's Shirt. — The shirt may be of flannel, merino 
or soft worsted yarn, the weight varying with the season. 
It should be made loose, with a high neck and long sleeves, 
and of a sufficient length to reach below the hips, where it 
is pinned to the diaper. Every part of the child must be 
protected from exposure; chilling of the arms is often suffi- 
cient to cause pneumonia or diarrhoea. The shirt may be 
open its whole length in front, being fastened by small, flat 




THE LITTLE MOTHER— A HEAVY RESPONSIBILITY. 

The older children are often a great kelp to t*he busy mother. 
The responsibility of an older daughter, as she takes the mother's 
burden, has its reward in the love of the little sisters and brothers. 



CLOTHING FOR INFANT AND CHILD 269 

buttons, or it may be open just at the neck where it is fast- 
ened with tape or buttons. 

The Petticoat. — The petticoat should be of white flan- 
nel, made in Princess style and either fastened in the back 
with one or two flat buttons or tied at the neck with a 
narrow ribbon. It should never be so long as to reach six 
to ten inches below the body, for then it prevents the child 
moving its legs freely. 

The Infant's Dress. — The simpler the dress is made the 
less will be the discomfort the baby is subjected to while 
being dressed and undressed, and the less will be the temp- 
tation to allow the garment to be worn too long without 
washing. The dress or slip may be made of cambric or 
nainsook. It should be a little longer than the petticoat 
and fastened behind with buttons or with a narrow ribbon. 
The sleeves should be long. In the Gertrude suit the shirt, 
petticoat and dress are made so that they are put on to- 
gether. 

The Baby's Socks. — The baby's socks should be cro- 
cheted or knitted of silk or soft, fine yarn. They should 
reach fully half way to the knee, where they may be held 
in position by a loosely-knitted ribbon, tape or cord, or by 
a narrow band of stitches. 

An Infant's Night Clothes. — At night an entirely differ- 
ent set of clothes must be worn, consisting of a binder, a 
diaper, a shirt and a long and roomy night slip. This last 
should be made of muslin in the summer, but in the winter 
is best made of canton flannel with a drawing string at the 
bottom. 

Other Garments Needed for the Baby. — In addition to 
its regular indoor clothes the baby will need a soft, warm 
flannel or woolen shoulder blanket, a cambric or silk cap 
or hood, a knitted or woolen sack, a flannel or wash-flannel 
wrapper, and also in the winter a long, warm cloak or coat, 



270 CLOTHING FOB INFANT AND CHILD 

a warm, thick hood or cap, a Shetland veil and thick, warm 
mittens. 

When the Baby Discards Long Clothes. — The baby 
wears long clothes for the first six months of its life, after 
which time, unless it be winter, it should be put into short 
clothes. 

THE BABY IN SHORT CLOTHES. 

Practically the only difference between short clothes 
and long clothes is in the length, the former ending a short 
distance below the knees and thus leaving the legs exposed. 
Short clothes may be made from the garments that have 
been worn' since birth by cutting down the skirts, length- 
ening the sleeves and letting out the waists. 

Stockings.— It is dangerous to allow the child's legs 
to be bare even in the summer-time. The baby should 
wear long, smooth, roomy stockings, covering both the leg 
and the thigh. They may be fastened to the diaper or to 
a waist or diaper suspender, or may be attached to the pet- 
ticoat by means of elastic bands. 

Drawers.— -Woolen, merino or canton-flannel drawers 
are of advantage in the winter. They are best made in two 
pieces, which should fit close and should reach to the shoe 
tops, being fastened or pinned to the waist of the petticoat. 
When these are worn there is not such a necessity for hav- 
ing long stockings; short stockings may be worn instead. 

Diaper-Supporters.— As the diapers have a tendency to 
■fall off when the child begins to creep and stand, they 
should be fastened to little squares of muslin sewed on the 
shirt, or to the tab on the abdominal binder. Another way 
to support them is by means of diaper suspenders. This 
consists of a band of muslin three inches wide fastened 
around the waist and provided with silk elastic shoulder 
straps. A little tab is sewed to the front of the band and 
another at the back; to these the diaper is pinned. Instead 



CLOTHING FOR INFANT AND CHILD 271 

of suspenders, a light waist may be worn, to which not only 
the diaper but also the stockings and skirts may be fast- 
ened, the skirts themselves in that case being made with- 
out waists. 

The Baby's Foot-gear. — Moccasins form an excellent 
covering for the feet before the baby begins to stand or 
creep. They may be made of chamois, leather, kid or felt. 
The first shoes a baby wears should be made of soft kid, 
with the soles also of kid or fine leather, and without heels. 
They should be somewhat longer than the foot and fully 
as wide. They should be made rights and lefts, and should 
lace rather than button. 

Bibs. — As the baby slobbers a great deal at this time, 
owing to the increased flow of saliva, it should be provided 
with bibs. These are made of soft, absorbent cotton ma- 
terial. 

The Creeping Apron. — When the baby begins to creep 
about it will need a creeping apron. This consists of a 
wide, roomy, bag-like skirt large enough to hold the skirts 
easily, and closed at the bottom, v/ith the exception of two 
openings, which are finished with bands or cuffs made to 
extend below the knees. The width of the skirt at the 
bottom should be twenty-seven inches or more, the distance 
between the openings for the legs being fifteen inches. The 
apron may either be fastened above to a yoke which is pro- 
vided with wide sleeves and wide armholes to permit the 
arms to slip into them easily or it may be gathered above 
into a band to which shoulder straps are attached. 

Outing Clothes. — The baby will need a shorter coat 
when it goes out, and in cold weather should have the whole 
lower half of the body covered with warm leggings, either 
knitted or made of jersey. 

The Binder, Night Slip and Wrapper.— While in short 
clothes the baby continues to wear the binder. During this 



2?2 CLOTHING FOR INFANT AND CHILD 

time the night slip and the wrapper should still be long and 
loose, not taking part in the general shortening. 

CHILDREN'S CLOTHING. 

As soon as the baby learns to do without a diaper it 
can discard the clothing of infancy. This stage is usually 
reached by the time a child is a year old, although it may 
occur earlier; on the other hand, it may be postponed to 
the end of the second year. The binder should be worn 
until the child is two years of age. 

A Child's Underwear. — The underclothing the whole 
year around should be of wool or merino, the thickness 
varying with the season. A change from heavy to light 
garments, however, should not be made until the hot 
weather has set in permanently. No part of the body, with 
the exception of the head and hands, should be left exposed 
to the air; consequently the underclothes must be made with 
high necks and long sleeves and legs. Short muslin drawers 
may be worn over the under-drawers, being attached to the 
waist. A white skirt is worn throughout the year, but dur- 
ing the winter the child must wear a flannel skirt in addition. 
The skirts may be fastened to the waist, or they may have 
muslin waists of their own. 

The Outer Garments. — The outer garments should be 
loose and warm, the material and pattern being in accord- 
ance with the season and the prevailing style. 

A Child's Shoes. — The shoes should be made heavier 
and decidedly thicker at the heel when the child begins to 
walk. An actual heel, however, should not be worn before 
the sixth or eight year. 

Clothing for Out-of-Doors. — In the winter-time for out- 
of-doors the child will require a heavy wrap or overcoat, a 
heavy cap or hood, mittens and leggings. These should 
be put on just before the child goes out and taken off im- 



CLOTHING FOR INFANT AND CHILD 273 

mediately upon coming in. Rubber coats, overshoes and 
boots must also be removed as soon as possible. When 
gum boots have been taken off, the feet and legs should be 
uncovered and rubbed with a coarse towel until the skin is 
red, after which dry stockings should be put on. 

Night Attire.— A light, high-neck, long-sleeved merino 
shirt should be put on at night after the removal of the 
clothing that has been worn during the day. The child 
should then be dressed in night drawers, which in winter- 
time should be made of canton flannel or cotton stockingette 
and provided with feet, but which in summer may be made 
of muslin, cambric or outing flannel, without feet. Later, 
as they increase in age, girls may wear night-gowns and 
boys may wear night-shirts or pajamas. 



CHAPTER XXVIII. 

THE BABY'S SLEEPING HOURS. 

Amount of sleep required. Regularity in sleeping hours. Baby's position when 
sleeping. Time for sleeping. Preparing baby for bed. The awakening 
in the morning. Ventilating the baby's sleeping room. The baby's bed: bas- 
sinet, cradle, crib, clothes-basket. How to make the baby's bed. How 
to keep on the covers. Care of the bed. Keeping the air of the sleeping 
room pure. 

"He smiles^ and sleeps ! — sleep en 
And smile, thou little young inheritor 
Of a world scarce less young; sleep on, and smile! 
Thine are the hours and days when both are cheering 
And innocent l M 

— Byron. 

AMOUNT OF SLEEP REQUIRED BY BABY AND CHILD. 

HE greater part of the early life of the healthy infant is 
spent in sleep. If a baby is fretful and does not sleep, 
one of two things is usually the matter: Either 
it is not well, or else it has been badly trained. 
For the first few months a normal baby should sleep eighteen 
or twenty hours a day. In fact, during the week or so after 
birth it will sleep almost all of the time and rouse only 
when nursed or bathed. As the baby grows older, it will 
awaken more frequently and for longer periods. If the 
baby is to grow up strong and healthy, it must have suffi- 
cient sleep. Mothers are often uninformed as to the number 
of hours which, at the different ages, babies ought to spend 
in sleep. Through ignorance they try to entertain and 
amuse the little one at a time when it should be taking 
its nap. 

-. .274 




THE BABY'S SLEEPING HOUHS 275 

Children a year old require fifteen or sixteen hours of 
sleep every day; between two and three years they should 
sleep twelve or thirteen hours out of the twenty-four; at 
four or five years they need ten or eleven hours of sleep. 
Even when children reach the age of twelve or thirteen 
years they require nine or tGti hours of sleep. 

REGULARITY IN SLEEPING HOURS. 

A baby properly trained rarely needs to be rocked to 
sleep; it will fall to sleep of its own accord when put to bed. 

Walking the floor with a healthy child, holding it in 
the arms, patting, rocking and singing to it are absolutely 
unnecessary; they give evidence of faulty training. A little 
firmness in the first few days of the infant's life will save 
the mother or nurse hours and days of misery and martyr- 
dom. The training cannot begin too early. The infant 
must be put to bed at definite hours, and the hours must 
never be varied. This will develop a habit of regularity 
in sleeping. 

When the hour for sleep arrives the baby should be 
put to bed and left there. Unless sick, it should not be 
taken up again to be soothed to sleep by patting, singing, 
rocking or walking. It is best that no one sit in the room 
with the child. At first the angry infant will cry loudly, 
whereupon the loving and tenderhearted mother will natu- 
rally long to take it in her arms until it is quieted. But if 
she yield once, she must be prepared to have this happen 
every time the child is put to bed. If, on the other hand, 
she persist in her determination not to go near her baby, 
she will find that after a while it will drop off to sleep. 

Having once learned its lesson, the baby will always 
go to sleep without any difficulty, provided it never knows 
any other way than this of being put to sleep. But should 
it ever learn that merely by crying it can have itself rocked 



276 THE BABY'S SLEEPING HOTJKS 

and sung to, it will take advantage of this knowledge at 
every opportunity. 

THE BABY'S POSITION WHEN SLEEPING. 

At birth, and for several days after, the baby should 
lie on its right side. This position aids certain changes 
which the child's heart undergoes when it takes on the 
work of pumping the blood, which before birth w r as done 
by the mother's heart. After the first few days of life it 
is immaterial what attitude the child assumes in bed; it 
may lie on its back, on either side, or on its stomach. It 
should not, however, remain in one position too long. 
When, therefore, the baby is too young or too feeble to 
move of its own accord, it should now and then be taken up 
by the mother and put down in a slightly altered position. 

TIME FOR SLEEPING. 

It is necessary not only that the child sleep a certain 
number of hours each day, but also that the sleeping hours 
be properly apportioned. There must be a definite time 
for going to bed, for getting up in the morning, and for 
taking the nap. 

For the first three or four months the baby should be 
put to bed at half past five or six o'clock. It should not be 
roused more often than once or twice during the night, and 
must sleep undisturbed for six full hours. In the early 
weeks it is allowed to sleep during the day as much as it 
will; but after it is a month old, if it is kept awake for 
about an hour previous to its bed time, it will be sure 
to have a better night's rest. When the infant is between 
four and six months of age it should be put to bed at six 
or seven in the evening, and sleep until six or seven in the 
morning. It may be awakened and fed at nine or ten 



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THE BABY'S SLEEPING HOURS 277 

P. M., but must not be taken up at any other time, so that 
it may become trained to awakening but once during the 
night. 

A child who is between six months and a year old should 
sleep from six or seven in the evening to six or seven in 
the morning, without being roused for feeding. It does 
not sleep so much now during the day, but should have a 
nap in the morning and may have another in the afternoon. 
The morning nap should last from one and a half to two 
hours. The time of day selected will depend largely upon 
the hours of feeding, which must not be interfered with, and 
upon the convenience of the mother, who may have other 
duties in addition to caring for the baby. If an afternoon 
nap be required, it should be over by four o'clock, lest it 
interfere with the night's rest. 

During its second year the child should be put to bed 
at night at the same time as before, and should be allowed 
to sleep uninterruptedly for twelve hours. In the morn- 
ing, at about eleven o'clock, the child should be undressed 
and put to bed in a darkened room and allowed to sleep 
for two hours. At this age an afternoon nap is not de- 
sirable. 

After the child is two years of age its morning nap is 
shortened to an hour or half an hour, but the night's rest 
remains the same. From tzvo to four years there is no 
change, except that the morning nap need not be insisted 
upon if the child objects to it. 

Children over four years should go to bed at eight 
o'clock or earlier, the hour being gradually changed from 
half past seven for little children to half past eight o'clock 
as the age of ten or tivclve years is reached. 

Preferably, the child should sleep undisturbed in the 
morning until he awakens of his own accord, though he may, 
if desirable, be roused at a fixed hour, not earlier than seven. 



S78 THE BABY'S SLEEPING HOURS 

He should never be awakened roughly or suddenly, but al- 
ways gently and gradually. 

These hours may have to be varied to suit the indi- 
vidual case. For example, if a child persistently awakens 
too early in the morning and does not fall asleep again, he 
should be allowed to go to bed at a later hour than the 
one given here; if he seems tired when aroused, he should 
be sent to bed earlier. Regularity in the hours of sleeping 
is as important in older children as in babies. 

For an hour before bed time the child should not in- 
dulge in romping games or in excitement of any kind. It 
may sleep badly in consequence. After a child is thor- 
oughly azvake in the morning, it must not be allowed to lie 
in bed, but should be immediately washed, dressed and fed. 

THE BABY'S BED. 

Wherever possible, the baby should sleep alone. There 
are several reasons for this. In the first place, the mother 
may accidentally lie on the baby and smother it. Again, 
if she sleep with it, she is less apt to nurse it regularly than 
if she has to get up for this purpose. She is also liable to 
pull the covers over the baby's head and thus deprive it 
of fresh air. 

The best bed for the first few months of the baby's life 
is the basket-bed or bassinet. The bassinet consists merely 
of a wicker basket with high sides. It may or may not 
have a hood over one end. It should stand high, so as to 
escape the draughts on the floor. It is usually covered out- 
side with Swiss muslin or something similar. It may be 
lined with some colored or white material. The decora- 
tions are best when simple and inexpensive, so that they 
may be changed upon becoming dusty or soiled. 

The baby's bed ma}/ be improvised from a large oval 
clothes-basket. For this the following articles are required: 



THE BABY'S SLEEPING HOURS 279 

A wicker basket; nine yards of natural colored tussore silk 
at about twenty-five cents a yard; about six yards of lace, 
the same color as the silk, and four yards of blue or pink 
ribbon, two inches in width. The depth of the silk will 
just cover the bed. 

Hem down one selvedge of the silk a sufficient width 
to frill it round the basket and run a reeving string in it; 
reeve it up to the required size and tack it here and there 
to the inside of the basket. It will reach to the wicker bar, 
which is usually placed a few inches down. This arrange- 
ment of the reeving string makes it very easy to take off 
the silk, so as to wash it when required. Line the bottom 
and sides of the basket with muslin or sateen, that there 
may be no draughts for the baby. 

All round the edge of the basket, over the silk, sew a 
frill of the lace and put a bow of the ribbon on each handle 
and at the foot and head of the basket. This makes a bed 
for the baby, at a very small cost, that is almost equal to 
anything that could be bought in the shops. Enough silk 
will then have been left to trim the baby's basket,* which 
should be made to match. 

The bed should be easily portable, so that it may be 
readily moved from one place to another. Curtains, while 
they keep out draughts, are apt at the same time to in- 
terfere with the supply of fresh air. They also catch the 
dust. The bassinet is superior to other beds for a baby 
as it gives the little body more support at the sides and 
allows more room for tucking in. 

A cradle is often used, but has serious disadvantages; 
the rockers are liable to trip people, and rocking itself is 
not good for the baby's training. 

The child should sleep in a crib from the time it is 



*See Chapter XIX. 



280 THE BABY'S SLEEPING HOURS 

eight or nine months old until it is five years of age. It may 
use one from birth if the sides be lined to cut off draughts 
and if pillows be placed at the sides to properly support the 
child. The crib may be made of wood or metal. Enameled 
iron is best, as it is the most easily cleansed. The sides 
should be high and may be either hinged or sliding. Cur- 
tains are open to the objections already given. The crib 
should be provided with springs or with a woven wire 
mattress. 

How to Make the Baby's Bed. — The baby's bed is 
made up the same, both in the crib and in the bassinet. The 
mattress should be soft and thin and made of hair rather 
than of feathers. Over the mattress is laid a rubber cloth 
or piece of mackintosh. In winter a quilted bed cover 
placed over this makes the bed softer and warmer. A 
doubled muslin sheet is laid over the rubber sheet or over 
the quilted bed cover when this is used. On the sheet, di- 
rectly under the baby, is placed a pad of nursery cloth, 
made as described in Chapter XIX, or a small pad, like the 
lap-protector described in Chapter XXVI. 

The upper coverings consist of a muslin sheet, as many 
soft blankets as may be required, and a light spread. In 
winter an eiderdown quilt may be added. The pillows 
should be small and thin, made of soft horse-hair and cov- 
ered with a fine linen pillow-slip. Very young infants may 
have a feather pillow. 

How to Keep On the Covers. — The head should never 
be covered, but the body should be protected by the bed- 
clothes throughout the night. Some children have a habit 
of kicking and throwing off the covers or of wriggling out- 
side of them. There are various means of preventing this 
occurrence. One way is to fasten the covers to the pillow 
with large safety pins but the best method consists in at- 
taching two short pieces of elastic to the covers by means 



THE BABY'S SLEEPING HOURS 281 

of a clamp, and tying them to the sides of the crib with 
pieces of ribbon or tape. The elastic allows the child to 
move about and turn, and at the same time prevents the 
covers from being tossed off. 

Care of the Bed. — Half an hour before the child is put 
to bed, the covers should be pulled down and the bed aired 
until the child gets in. It is well, except in hot weather, 
to warm the sheets by introducing a warming pan or by 
heating the sheets before the fire or radiator. 

The bed should be aired thoroughly every morning. The 
bedclothes should be removed and, with the mattress, ex- 
posed for at least two hours to the sun and air in a room 
with the windows wide open. Whenever a sheet becomes 
wet or soiled it should be changed at once. The bed should 
be remade at night if this occurs then. 

KEEPING THE AIR OF THE SLEEPING ROOM PURE. 

The baby's sleeping room should contain plenty of 
fresh air without subjecting the child to draught. Various 
methods of ventilating a room are described in Chapter 
XXXI. 

Flowers and plants may remain in the room during the 
hours of sunlight but must be removed when darkness 
supervenes; in the presence of sunlight they help to purify 
the air of the room but at other times they tend to vitiate 
it by using up the oxygen. 

Artificial lights, with the exception of electric light, 
also consume oxygen. Gas not only robs the air of oxygen 
but increases its impurities as well. With the use of the 
incandescent mantle, however, this defect is reduced to a 
minimum. An advantage of the gas flame is that it may 
be turned down very low and raised again in a moment. 
Electric lights have the disadvantage that they cannot be 
lowered. Candles vitiate the air more than anv other light. 



282 THE BABY'S SLEEPING HOURS 

Lamps often smell bad and are in danger of exploding or 
of being upset. There is usually no need of having a light 
while the child is asleep. Sometimes, however, when the 
baby is sick or must be roused frequently, it may be neces- 
sary to have a light all night long. For this purpose a 
night-lamp is best, as it burns with a faint glow and con- 
sumes relatively little oxygen. A small glass chimney 
makes the flame steadier and protects it from draughts. 
The candle that furnishes the light is surrounded by a thin 
layer of plaster of Paris which insures perfect safety. It is 
even possible to protect the child from the faint glimmer of 
such a light by fitting over it a dark metal shade with an 
opening on one side. German floating lights are also em- 
ployed. Portable electric lights operated with storage bat- 
teries are serviceable. They will burn continuously for six 
to eight hours or will give several hundred brief illumina- 
tions before new batteries are required. 



CHAPTER XXIX. 
EXERCISING AND AMUSING THE BABY, 



Exercising the Baby: The infant's first airing; the proper method of holding 
a new-born infant; taking the baby out; how to carry an older baby; the 
baby's first exercise; when the baby can hold its head up unsupported; after 
the child can stand and walk. Amusing the Baby: Toys for baby and 
child; How to make playthings at home. Games that exercise as well 
as amuse the child. 

"By sports like these are all their cares beguil'd ; 
The sports of children satisfy the child." 

— Goldsmith. 



EXERCISING THE BABY. 

HE Infant's First Airing. — When the infant is three 

or four days old it may be placed on its back on a 

pillow two or three times a day and carried about 

the room for ten or fifteen minutes at a time. When 

it is two weeks of age it may, properly supported, be taken 

up in the arms and carried into a somewhat cooler room. 

The Proper Method of Holding a New-born Infant. — 
The common method of holding a young infant by grasping 
the chest under the arms is incorrect. When the baby is 
to be lifted one hand should raise the lower portion of the 
body while the other is slipped under the back and head 
so as to support them, the child resting on the outstretched 
palms. After the first month the infant may be carried in 
the arms with its head and body well supported. 

Serious deformities have resulted from improper meth- 
ods of holding a baby; the spine especially may bend if un- 
supported. 

Taking the Baby Out. — In the summer-time a baby one 
month old may be taken in the arms and carried out into 

283 




284 EXERCISING AND AMUSING THE BABY 

the open air during the hours of daylight for ten or fifteen 
minutes on its first outing and for longer periods on subse- 
quent occasions. In the winter-time it sometimes is well 
not to take the child out at all until it is two or three months 
of age. The best time for the outing in the winter is be- 
tween the hours of ten and three, while the sun is strong. 
When there is an objection to taking the baby outside, the 
windows of the room may be thrown wide open and the 
baby, thoroughly wrapped up, may be carried in the arms 
about the room for half an hour or so. On cold or damp 
days, however, it is best that the windows be first opened 
for an hour and then closed before the baby is brought into 
the room. 

How to Carry an Older Baby.— At the age of three or 
four months the baby may be seated upon the nurse's arm, 
its head and shoulders being supported by the hand of the 
other side. As the child gets older the support of its back 
and head is not always necessary. It is well to carry the 
child alternately on each arm, in order to prevent its spine 
becoming curved. 

The Baby's First Exercise. — After the fourth month 
the child may be placed several times a day on a blanket 
or soft mattress or in a clothes basket or large, padded box, 
with its clothes so arranged that it can freely kick and move 
about. It is important in winter or bad weather to see that 
the child, when thus playing about, is not exposed to 
draughts; when the child has catarrh of the head, chest or 
bowels it should be kept off the floor. A creeping pen will 
be of service when the child begins to crawl about. 

Professor Griffith condemns the common practice of 
trotting the baby on the knee. He says that when one 
compares the diminutive size of the baby lying on its back 
or stomach in the nurse's arms with the vigor of the trot- 
ting to which it is subjected there can be no surprise if 




CHILDHOOD'S ELOQUENT AFFECTION. 

The artist has beautifully caught the spirit of love and affection 
with which the baby is welcomed into the family by the older brother 
or sister. The mother's joy is complete in this bond of love. 



EXERCISING AND AMUSING THE BABY 285 

vomiting or other disturbances of digestion are produced. 
And even should these not occur the baby may learn to de- 
pend on this hard usage for going to sleep. 

When the baby reaches the age of three or four months 
it may spend the greater part of the time in the open air 
if the temperature be warm and the weather clear. During 
the daytime it may even be permitted to sleep out-of-doors. 
It is now usually taken out in a perambulator or baby car- 
riage. The coach should be well balanced and smoothly 
running, giving the child support at the sides and being 
provided with a dark-colored, adjustable sun-shade, which 
should always protect the baby's face from the sun. The 
infant should lie upon a soft bed and pillow, protected with 
warm covers, such as a knitted or crocheted afghan. 

When the Baby Can Hold Its Head Up Unsupported. 
—At eight months of age the child no longer will need to 
have its head supported when it is carried. It may then sit 
up in its coach on an adjustable seat, propped at the back 
and sides with extra pillows. To prevent the child from 
falling out, the carriage should be provided with a strap 
which goes entirely around the baby's waist, being attached 
by smaller straps to the sides of the coach. The baby can 
climb over or crawl under the straight strap which is fast- 
ened across the coach in front of the child. 

After the Child Can Stand and Walk.— At the end of 
the first year the child will make attempts at standing, and 
some months later will begin to walk. But he must be 
allowed to do so unassisted and without urging or coaxing. 
When the child is able to walk fairly well he may be taken 
out of the coach for ten or fifteen minutes at a time and 
permitted to exercise on his feet. The duration of this daily 
stroll is increased gradually until at the age of two and a 
half or three years of age the child may walk possibly half 
a mile. By this time, if the child has outgrown his coach 



286 EXEKCISING AND AMUSING THE BABY 

or becomes tired of it, he may ride in a go-cart, an express 
wagon or one of the various forms of children's wagons. 
In the winter he may be pulled about on a sled. 

As the child grows older he will be able to take more 
and more exercise without fatigue. Those games should 
be encouraged that develop every portion of the body and 
bring into play the different muscles. A rocking-horse can 
be used in the nursery; outside the house the child may 
exercise by rolling a hoop or riding a velocipede, or by 
skipping the rope. The latter is a very good form of exer- 
cise if not indulged in for too long a time, or with too 
rapid jumping. The practice of seeing how many times or 
how fast one can jump has been responsible for many sud- 
den deaths. 

When the child grows older any of the games or sports 
mentioned in chapter VII can be indulged in. There are 
also many games adapted especially to little children, such 
as those played in the kindergartens. The games of older chil- 
dren are described later in this chapter. 



AMUSING THE BABY. 

An infant should not be amused all the time; discon- 
tent is frequently the consequence, the child always craving 
fresh pleasures and excitement. While still very young it 
may be left alone for a short space of time, when it will 
learn to play with itself. Nevertheless, a certain amount 
of distraction is often necessary to prevent the baby's be- 
coming bored, fretful and irritable. There are any number 
of finger games that a mother can play with her baby, such 
as "This little pig went to market." A common finger-play 
used a great deal in the kindergarten is "Thumbkin says, 
Til dance !' " The mother makes the thumb and then each 
finger in turn dance as she sings about them; all the fingers, 



EXERCISING AND AMUSING THE BABY 287 

however, dance together at the words "Dance and sing, ye 
merry little men I" During the last verse the fingers remain 
folded. The song is: 

1. Thumbkin says, "I'll dance!" 
Thumbkin says, "I'll sing!" 

Dance and sing, ye merry little men; 
Thumbkin says, "I'll dance and sing!" 

2. Pointer says, "I'll dance!" 
Pointer says, "I'll sing!" 
Dance and sing, etc. 

3. Tall man says, "I'll dance!" etc. 

4. Ring man says, "I'll dance!" etc. 

5. Little man says, "I'll dance!" etc. 

6. All the men say they'll dance! etc. 

7. All the men say they'll rest! etc. 

Another finger game is to put a nutshell or thimble on 
each finger and rattle the fingers about to make them sound 
to the words — 

"Rittle rattle, tittle tattle, 
All the soldiers rush to battle! 
Hear each rover land at Dover, 
When he finds the battle over!" 

A slow race between the first and second fingers will often 
amuse the baby, the mother saying : 

"Creepy-crawly, yeeny-yawny, 

Like two lazy snails; 
Let each tread a drowsy head, 

Near our lazy tails. [Here doubling the fingers up.] 
Ned, good-night, boy — Fred, good-night, boy— 

Both began to snore. 
Then this crawled out, then that drawled out [opening them], 

Dawdling as before." 

By making knots in a handkerchief and placing them on 

the fingers, amusing little games may be acted. Two lingers 
with a little piece of paper arranged round them as a petticoat 
may be made to dance. A good imitation baby may be made 
by painting two eves and a mouth on the back of the hand and 



2S8 EXERCISING AND AMUSING THE BABY 

wrapping the hand and arm in a table napkin made to look like 
a hood and long clothes. Faces drawn with ink on the back 
of the ringer nails make five jolly companions, who can go 
through all sorts of talk and performances, or who may be 
children in a school and answer questions. 

One should avoid, however, playing with the child just 
before its sleeping hour. 

Toys for Baby and Child.— After the age of five or six 
months the child may be amused by a rubber rattle or other 
toy which makes a noise, and with a rubber or bright 
worsted doll. Playthings that an infant is constantly put- 
ting into its mouth should be frequently and thoroughly 
cleansed. Very useful toys are those that instruct, such as 
picture blocks, a Noah's Ark and the like. If a child is 
given many expensive and fragile toys it soon becomes dis- 
contented with what it has and is always wanting some- 
thing new. It is a good plan to put away for a month a 
toy the child has become tired of, at the end of which 
period it will be welcomed as a novelty or as an old friend. 
The child also learns destructive habits if he plays with 
fragile toys. It is therefore desirable to give him toys 
selected for their quality and durability. 

Little children are always interested in seeing objects 
cut out of paper or made by folding a piece of paper. Very 
pretty scrap books may be made by pasting the pictures 
from illustrated newspapers and magazines upon sheets of 
paper or unbleached linen or in a large scrap book. Where 
a mother cannot afford to buy toys for her child she can often 
make them at home. The child itself may be taught to make 
its own toys, thus obtaining from them instruction as well as 
pleasure. 

A fine galloping horse can be made of cork with four 
burnt matches as legs, the black ends of the matches forming 
the hoofs. The head and tail are cut out of cardboard, the 



EXERCISING AND AMUSING THE BABY 289 

features, mane and hairs of the tail being marked on it with ink. 
A very passable ship can be made from a walnut shell by cut- 
ting a piece of cork to fill the shell and form the deck, sticking 
burnt matches into it for masts and bowsprit, and making the 
rigging of cotton. 

A cheap dolls' house may be made from an old packing- 
case, turned up on one end, with the cover split up to make 
floor and walls. The front of the dolls' house should be made 
of stout cardboard attached to the case by means of a stiff 
piece of unbleached linen glued to one side of the box so that 
the cardboard front will open easily. Spaces for the windows 
and doors are cut out. Pieces of glazed paper may be glued 
on with strips of linen to form the windows, and the cut-out 
door may be hinged in the same way as the front of the house. 
The whole may be painted or enameled; the walls may be 
papered, and the floors covered with bits of carpets or strips 
of paper woven as in the kindergarten mat-making. Little 
strips of cretonne can be fastened as curtains in the windows. 
The furniture can be made out of odds and ends. 

A kitchen table may be made of a piece of cigar box, with 
four sticks for legs. To make an armchair, stick two corks 
together for a seat; put four burnt matches as legs and six to 
form the back of the chair. Cover the legs and back with 
wool, and use a little piece of chintz or silk as a cushion. To 
make a chest of drawers, take six small matchboxes, glue the 
outside cases firmly together in two piles of three each, fixing 
the sides down the center. This forms a framework for six 
drawers. Paint the framework and front ends with two coats 
of enamel, and fasten small buttons with shanks into the ends 
to form handles. The top and sides may be covered with a 
piece of silk. 

To make a bassinette for a dolls' house, take the insides 

of two matchboxes, stand one up to form the head, and fix the 

Other inside it. Paste a piece of pink or blue silk or calico 
19 



290 EXERCISING AND AMUSING THE BABY 

over the whole to make it strong, and then put over the sides 
a frill of silk or sateen, covered with muslin, fastening it inside 
the wall of the box about half-way down. Turn this over to 
make a frill round the outside, gathering it again just below 
the top. A larger bassinette, which will hold a good-sized doll, 
can be made out of a larger box, which can be trimmed in the 
same way. A round strawberry basket covered to match the 
bassinette, with little pockets sewn inside in the lining, looks 
very pretty when finished, and will hold the doll's clothes. A 
tiny cradle can be made from a walnut-shell. A scrap of wool 
with a piece of calico makes a good mattress, and any little piece 
of colored material makes a nice coverlet. Tiny china dolls of 
a suitable size to get into it may be bought for little money. 

Games that Exercise and Amuse Older Children. — 
There are many games which will both amuse the children 
and yet exercise all the muscles of their little bodies. One 
of these is the game of "Over/' in which the children are 
divided equally into two lines stationed about five feet apart. 
The children of each line stand close to one another with 
their arms up, as in the illustration. The first one of each 
line, who is the captain, is given a large ball or bean bag, 
which, at a given signal, he passes back, each child in turn 
passing it over his head to the one behind him. When the 
last child in the line receives the ball he runs forward to 
the head of the line, while all the others take a step back. 
The ball is then passed back in the same manner as before, 
this being repeated until the captain becomes the end man. 
Upon receiving the ball he runs forward to the head of the 
line again and places the ball upon the floor. Whichever 
line finishes first wins. If the ball should be dropped it must 
be returned to the one that dropped it before it can con- 
tinue on its way. 

In the game of "Under" the children are also divided 
into two lines, but those in each line stand at least one yard 



EXERCISING AND AMUSING THE BABY 291 

from each other, separating their feet and bending their 
bodies forward. The captain of each line at a given signal 
starts to roll the ball or bean bag back between his legs 
to the one behind. Each child on receiving the ball rolls 
it between his legs to the one behind so that it will go as 
far and as quickly as possible. When the one on the end 
receives the ball he runs to the head of the line, while the 
others take one step backward, and the game is continued 
as in the previous one until the captain is again at the head 
of the line. An even greater amount of exercise is given 
when the two games are played alternately. 

It would be impossible in a work of this character to 
describe in detail all the excellent games that may be played 
by children. The few mentioned serve to indicate how a 
child's development may be favorably influenced by well- 
directed games. 



CHAPTER XXX. 
MENTAL AND MORAL TRAINING. 



The moulding of character lies in the mother's hands. The control of the 
bladder and bowels. How to deal with children. A child's sensitiveness. 
Children's questions. Kindness and gentleness. A child requires pleasure. 
Politeness. Children's fears. The child a great imitator. How children 
learn conduct. Practice vs. precept. Making a child truthful. Children's 
imagination and temper. Obedience and how to enforce it. The spoiled 
Child. Threats and punishment. Order and neatness. Learning to talk. 
The use of money. Children's pets. Stories told to children. Children 
in the society of their elders: before company; at the table. Education: 
Kindergarten, School. The training of backward and mentally deficient 
children. 

"Delightful task ! to rear the tender thought, 
To teach the young idea how to shoot, 
To pour the fresh instruction o'er the mind, 
To breathe the enlivening spirit and to fix 
The generous purpose in the glowing breast." 

— Thomson, 



THE MOULDING OF CHARACTER LIES IN THE MOTHER'S HANDS. 



O 



NE of the most important duties of parents is to train 
the child so that it will grow up strong in mind and 
in morals, as well as in body. In the mother's hands 
largely lies the moulding of the child's character. 
The mental and moral attitude of a man is due in great 
part to his early training. The mother decides the destiny 
for good or evil. A woman may fail in this duty through 
ignorance or inexperience, especially if her own early train- 
ing was faulty. It is to furnish some guide to the inex- 
perienced that this chapter has been written. The child 
should have the first claim on the mother's time, which 

292 



MENTAL AND MORAL TRAINING 283 

claim should not be interfered with by demands of public 
interest, of society, or of fashion. 

With the development of the child's character the 
mother's character is likewise broadened. One reacts on 
the other; the training is a mutual education. 

THE CONTROL OF THE BLADDER AND BOWELS. 

The mother or nurse cannot begin too early to train 
the child in the control of the bladder and the bowels. These 
acts are usually performed with some regularity even in 
babies, the bladder usually being emptied after each feeding. 
At the time of the expected evacuation the mother or nurse 
should hold the baby over a receptacle. She may make some 
sound that the child will learn to associate with the act. 
After a time the child will learn to recognize the purpose of 
the procedure and be guided accordingly. 

When the baby is old enough to sit up it may be 
placed in the nursery chair at the proper time. Mothers 
should observe the greatest regularity in this, in order to 
train the baby properly. Most children have acquired con- 
trol by the time they are eighteen months old, many at the 
age of a year, or even less. All should have done so at 
the end of the second year at the latest. The training 
should be conducted by patience and perseverance, not by 
punishments. 

HOW TO DEAL WITH CHILDREN. 

A Child's Sensitiveness. — Little children are extremely 
sensitive and are often made very miserable by a slight 
action or a thoughtless word. They may look back for 
years with painful recollections upon an expression of ridi- 
cule. Children usually may be won over by words of praise 
and small deeds of kindness but are often alienated by little 
acts of thoughtlessness, neglect or impatience. 



294 MENTAL AND MORAL TRAINING 

Children's Questions. — The constant questioning of 
little children is often very trying but should not be dis- 
regarded or rudely repulsed. It should be borne with pa- 
tience and even encouraged unless it is out of place, when it 
must be gently checked. 

Kindness and Gentleness in Dealing with Children. — 
Children have to learn not to make a noise which comes 
natural to them; this should be taught them gently and 
not harshly. No one should be cross or impatient in deal- 
ing with a child. If a mother feels irritable and not quite 
well she had better leave her children for a few hours and 
take a rest if she possibly can. Both mother and nurse 
should avoid using harsh language of any kind and must 
always give their commands quietly and not roughly. Chil- 
dren that are constantly reproved and reprimanded are very 
apt when they grow up to be impatient of all control and 
to be unable to govern their own passions. 

When asking a favor of a child, one should always say 
"Please" and "Thank you," else one cannot expect the child 
to use these expressions. 

A Child Requires Pleasure. — The child's life should be 
as full of pleasure and of change as possible, monotony be- 
ing very trying to the young, active mind. 

THE CHILD A GREAT IMITATOR. 

Children learn conduct, as they learn other things, by, 
observation. They learn that chairs are things to sit upon, 
because they see people sitting on them. In the same way 
a child learns that certain things are proper to do because 
he sees others doing them. 

Practice versus Precept. — If children come to realize 
that in their daily lives there is a difference between teach- 
ing and conduct and that the precepts taught them are by 



MENTAL AND MORAL TRAINING 295 

no means acted out by those who teach them, they will 
learn to receive the instruction more as abstract propo- 
sitions than as living facts. We cannot expect children to 
have reasonable conviction, but we may be sure that they 
will readily enough follow repeated example. The child 
must live in a constant atmosphere of the kind of life that 
it is supposed to lead. He will learn much more from this 
atmosphere than from any other teaching to which he may 
be subjected. 

Making a Child Truthful. — It is not sufficient to tell a 
child not to tell a falsehood; the child itself must never be 
told a falsehood by its parents or nurse. If, in addition to 
being taught not to lie the child is never told an untruth, 
he will run little danger of becoming untruthful. Punish- 
ing a child for a fault after he has told the truth about it 
only runs the risk of encouraging him to lie on the next 
occasion. 

Children's Imagination and Temper. — The vivid imag- 
ination of the child causes him to regard many of his ab- 
surd fancies as true. He may tell all manner of false stories 
which, for the time, he may actually believe. This romanc- 
ing has no connection with deliberate lying and should be 
distinguished from it. 

A baby is so imitative that his temper and habits of 
mind and body are ostensibly copied from examples about 
him. That is why quiet tones, cheerful manners and loving 
and tender ways should be used in all one's associations 
with a child. 

CHILDREN'S FEARS. 

The child should be taught not to have an unreasoning 
fear. This is done by the caretaker herself not showing 
any fear. The child should never be frightened in any way, 
never shown terrible sights or told horrible tales. Toys, 



296 MENTAL AND MORAL TRAINING 

such as a jack-in-the-box, should never be given to him. 
Imaginary fears of children, however, require very careful 
handling and should be gently explained away. 

OBEDIENCE AND HOW TO ENFORCE IT. 

The child should be taught to obey implicitly and with- 
out questioning. It is a great mistake for a mother to offer 
a reward to a child for obeying some command. By such 
means a child learns to regard his act of obedience as a 
favor to the parent in return for full value received. The 
child must learn to obey because he is commanded by his 
parent and for no other reason. On the other hand, the 
mother must avoid being tyrannical, exacting or unreason- 
able. She must always bear in mind that the child may be 
in the right. It is always well to explain to the child what 
he does not understand, but this explanation should never 
be made a condition of obedience. That is to say, the com- 
mand of the parent does not have to be explained before 
the child must obey it. 

Firmness a Requisite in the Mother. — Very early in 
the child's life the mother and the nurse must learn not to 
give in to the child simply because he cries. To let him 
have his own way is much easier, of course, than to argue 
or fight with him. A fond mother who in her anxiety to 
gratify every whim of her little one yields to his every desire 
is doing the child incalculable harm. The mother must be 
able to say "No" and the child must be taught to take "No" 
for an answer. 

The Spoiled Child. — In a scrap-book belonging to a 
mother who has brought up a large family the author came 
upon the following selection: 

"It is so infinitely easier to spoil a child than it is to 
train him wisely, to give him the thing refused a moment 
before because he cries for it and the noise he makes is an 




HAPPY PLAYTIME HOURS. 

The boundless buoyancy of children is a sign of happy hearts 
and healthy bodies, and should be curbed only when very uecess 
and then with not too harsh a rebuke. 



MENTAL AND MOHAL TRAINING 297 

annoyance. * * * Heavens, the patience of all the angels 
combined is needed to make one perfect mother. The 
responsibility has no let-up to it; it is line upon line and 
precept upon precept, in season and out of season, and even 
then suppose one should fail? It must be terrible for a 
parent to see the unrestrained passions of a well-grown 
child, to watch his violent temper if angered, his sullen 
sulkiness if thwarted, his selfish, uncheerful manner to 
those around him, and to have conscience say: 'That is 
all your work; you spoiled him because it was too much 
trouble to train him properly. If you had instructed him 
in gentleness and forgiveness and self-control, he could 
never exhibit such ungoverned rage ; if you had denied him 
things with firmness, and taught him to bear disappoint- 
ments, he would not to-day make your heart ache with 
those black looks and with sulky silence; had you early 
taught him to be generous in thought and in deed, and had 
impressed upon him that a certain amount of cheery friend- 
ship is due one mortal from another, you would not have 
been forced to blush for his loutish ungraciousness of de- 
meanor.'" 

THREATS AND PUNISHMENTS. 

A mother should never use a threat unless she intends 
to carry it out. When a child finds that after committing 
an offense he does not receive the punishment with which 
he was threatened, he will soon learn to despise the parent's 
command and in time will learn to distrust all the threats 
that are made him. But if he receives the threatened pun- 
ishment he will respect and believe in the parent and trust 
her afterwards and possibly on the next occasion will be 
sufficiently influenced by the threat alone. 

Punishments. — The punishment should be administered 
soon after the act has been committed, and not be post- 
poned until the child has forgotten all about his naughti- 



298 MENTAL AND MORAL TRAINING 

ness. Punishments should never be employed unless they 
are really necessary, and then they should be given in pro- 
portion to the offense and not in proportion to the resent- 
ment of the parent. They should never be given in anger. 
The child should be punished for the forbidden act rather 
than for the results of the act. If he is told not to throw 
his ball about the room, he should be punished when he 
disobeys, not punished only when he breaks a window. Nor 
should his disobedience be punished only when the mother 
is out of sorts, and be laughed at when she is in a good 
humor. The child should never be scolded for an accident 
which could not have been avoided, such as upsetting his 
cup or breaking anything, when this is merely due to the 
clumsiness of untrained hands. 

The nature of the punishment should be carefully con- 
sidered. Punishments that frighten the child or produce 
injury must be avoided. Boxing on the ears, for instance, 
may cause permanent damage to these organs and imprison- 
ment in an unventilated closet deprives the child of fresh air. 

HABITS OF ORDER AND NEATNESS. 

The child should be taught habits of neatness — to keep 
his toys in order and put them away carefully when through 
with them. He should arrange his clothing neatly on un- 
dressing for the night. When coming in from outside he 
should hang up his hat and coat in their proper places. 

LEARNING TO TALK. 

The age at which a child learns to talk varies greatly 
in different children. One infant may begin to make in- 
telligible sounds at the age of eight months, while another 
may not be able to make itself understood until two years 
of age. Children who learn to speak at an early age are 



MENTAL AND MORAL TRAINING 299 

not necessarily more intelligent than those who do not talk 
until later. The child should be encouraged but not forced 
when learning to talk. Mothers should never use baby 
talk in conversing with a child. This nonsense is not in- 
telligible to the child and often impedes its progress in real 
talking. 

If the child seems to have some impediment in its 
speech it should be taken to a physician. There need be 
no cause for anxiety if the child is backward in speaking, 
provided it shows intelligence in other ways. 

TRAINING IN THE USE OF MONEY. 

It is not a bad idea to train children at an early age 
in the use of money. A small weekly allowance might be 
given the child, the amount depending upon the age of 
the child and the wealth of the parents. Or the child might 
be rewarded when it does some useful work, such as weed- 
ing the garden or hemming a pocket handkerchief. At the 
same time the child should be taught how to practice econ- 
omy. As soon as the child has had some training in arith- 
metic he should be taught to keep an account of the amounts 
that he receives and spends, recording them in a book pro- 
vided for the purpose. In this way he will grow up knowing 
the value of money and the care of it. 

CHILDREN'S PETS. 

There is a distinct educational value in allowing a child 
to have the care, or partial care, of a pet of some kind. 
Pets may be the means of rendering their little masters and 
mistresses kind, humane and thoughtful, and increasing 
their love and sympathy for objects in nature. 

The child should be taught that an animal is sensitive 



300 MENTAL AND MORAL TRAINING 

and suffers pain, and he should always be punished when 
guilty of cruelty towards one. He should be taught to feed 
his pet regularly, to make its bed if necessary. In this way 
a sense of responsibility and of duty towards one's fellow 
creatures is imparted. 

STORIES TOLD TO CHILDREN. 

Parents should use great caution in the choice of stories 
that are told or read to little children. Stories of ghosts 
and goblins are often the cause of an unreasoning fear in 
the child. The wolf, the bears, and the giants of the familiar 
fairy stories may haunt the child at night. Goody-goody 
books are objectionable; also stories which excite the imag- 
ination too vividly or too painfully, such as tales of sorrow 
and injustice. 

Every time a certain little boy heard "Cock Robin/' 
he used to weep bitterly at the end of the lines: 

"All the birds of the air fell to sighing and sobbin* 
When they heard the bell tolled for poor Cock Robin/' 

Mrs. Ballin, in speaking on this subject, says: "I re- 
member that in a very nice little song book we had there 
was a song about 'A poor little baa, Who wandered away 
from his own mamma/ and this so affected my brother, who 
thought how dreadful it would be if he were separated 
from his own mamma, that if any allusion to the song was 
ever made, he would burst into tears and refuse to be com- 
forted. Even now, man as he is, he declares that he can- 
not bear allusion to this song without an uncomfortable 
feeling. This being so, it is easy to imagine how much 
harm may be done to children by an injudicious choice of 
books. Once, accidentally, a toy book was put into my 
hands in which there was a description and a picture of a 
race of gnomes who had six toes on each foot and no toe- 



MENTAL AND MORAL TRAINING 301 

nails. I have now a vivid feeling of the horror this caused 
me. I dreamed of it night after night, and it made me quite 
ill. Undoubtedly, the minds of impressionable and nervous 
children may be seriously affected by this means. Yet this 
is the sort of book that is largely produced, and which chil- 
dren are supposed to enjoy." 

Mothers should be careful about the paper and type 
of the books their children read, and about the positions 
they assume when reading. 

CHILDREN IN THE SOCIETY OF THEIR ELDERS. 

The child should see enough of company to become 
accustomed to strangers, but it should not be brought into 
the parlor or drawing-room to be admired by visitors. It 
should not be shown off by being made to recite and to sing 
or to excite admiration generally. 

By mixing too much in grown-up society, children be- 
come conceited and artificial. They interrupt the conversa- 
tion of their elders and are annoyed if they are not noticed 
and admired or praised. They are apt to repeat much that 
they hear and when checked for being too communicative 
are apt to become deceitful in consequence. As children 
should not be excited before going to bed, they should have 
their parties in the afternoon rather than in the evening. 

Children at the Table. — It is a question whether chil- 
dren should be allowed to come to the general table or 
should be given their meals by themselves in the nursery. 
It might be well while the child is very young for it to take 
its evening meal, at least, away from the excitement of the 
general dinner table. There seems to be no reason, how- 
ever, why the child should not take its breakfast or its mid- 
day meal with the rest of the family. 

As soon as the child reaches the age of two and a half 
or three years it should begin to take all its meals at the 



302 MENTAL AND MORAL TRAINING 

general table, unless company is present. The child will 
thus learn better table manners than if it eats by itself. It 
must be taught, however, to behave quietly while at the 
table, and should not be permitted to join in the conver- 
sation. As the child gets older, however, and becomes able 
to talk intelligently, topics for conversation may be chosen 
in which it can join. 

COMPANIONSHIP OF OTHER CHILDREN. 

It is wrong for children to be deprived of the society 
of those of their own age and to associate only with adults. 
Grown people, however kind and judicious they may be, 
cannot enter into the thoughts and aspirations, the little 
hopes and fears, pleasures and disappointments of the child. 
They often have neither the time nor the patience to listen 
to the prattle which the little one longs to pour into some 
appreciative ear. They are often indifferent to the tjrirles 
which the child considers of such great importance. 

The companionship of other children is necessary. A 
child who is accustomed to have playfellows of its own age 
learns that there are other beings in the world possessing 
the same abilities as itself, enjoying the same pleasures and 
suffering the same pains. The child becomes more natural 
than when it is constantly with adults, and loses its shy- 
ness and over-sensitiveness. When children play together, 
however, it is important for the mother to have some super- 
vision over their morals. At no age are they too young 
to need this watchfulness. The fact that a child appears 
innocent is no indication that it necessarily is so. 

THE EDUCATION OF CHILDREN. 

Children may be sent to a kindergarten when three or 
four years old. Here the child acquires knowledge by play. 
At the same time that it is amused it learns a certain degree 



MENTAL AND MORAL TRAINING 302 

of discipline and self-rule. The eye and hand are trained by 
weaving colored papers or making various designs. 

The child should not go to school until he is six or seven 
years old. The daily session should not exceed three hours 
for very young children or six hours for older ones. There 
should be one or two intermissions or recesses in each ses- 
sion during which the children should play in the open air. 
Physical exercises should be taught in the school. Too 
much time should not be spent in home study. Children 
should be taught to study for the sake of the knowledge 
gained rather than to compete with others or to get high 
marks. The general development, the progress and the 
individuality of each child should be considered in educa- 
tion. The precocious child is to be restrained rather than 
stimulated by exhibition and applause. The backward child 
should receive kind encouragement and not be punished or 
degraded. 

The school-room should be well ventilated and should 
not be too crowded. If the child complains of headache, or 
of difficulty in seeing the board, or of the printed page be- 
coming blurred, he should have his eyes attended to. Many 
of the leading cities of the United States have established 
medical inspection of the public schools — an excellent plan, 
which should be adopted by all communities. 

THE TRAINING OF BACKWARD AND MENTALLY DEFICIENT 

CHILDREN. 

A child who is mentally deficient can be best educated 
at an institution where the teachers are fitted by training 
and experience for their work. In most of the larger cities 
there are special schools for backward children. 

In caring for such children at home it is necessary first 
to cause as soon as possible the formation of correct habits. 
There should be a regular time for the evacuation of the 



304 MENTAL AND MORAL TRAINING 

bladder and bowels. Some advise the giving of an enema 
daily. Destructive tendencies in a mentally deficient child 
are not due to wickedness but to an inability to control its 
morbid impulses. The cure is difficult. Miss Bancroft thus 
describes the method she adopts at her training-school: 

"We have a little boy who has been with us a year. 
When he came, if he saw a flower, vase or book, his impulse 
was to throw away the flower, dash over the vase and tear 
the book. He is now in a room that is as sweet and pretty as 
can be, and he destroys very little in that room. He has been 
trained to handle flowers and to look at books and vases, not 
to toss or break or tear. He does this, except on very rare 
occasions, under the direction and control of an attendant 
or teacher who uses his hand as she would her own if she 
were handling the article. Then he is taught to bring the 
article to his attendant or teacher. If he does this without 
tearing it, he gets a piece of candy, so that gradually he gets 
an idea of associating something pleasant with the occasions 
when he sees these things, but does not destroy them. The 
process is, of course, slow; but, being founded on a rational 
knowledge of the condition, is sure. With other children 
we use different methods. A little girl would, in certain 
nervous paroxysms, break tumblers at meal time. For a few 
meals she was put at a table where she had to use a tin cup 
until 'her hands got well.' When they were perfectly well, 
so that they would not hurt her tumbler, she was allowed 
to come back again and use her tumbler. The method of 
treatment proved speedily efficacious; hand and tumbler 
were soon restored to their former friendly relations." 

It is most essential that these children should live in 
strict accordance with the rules of hygiene laid down in this 
book. Any physical defects, such as eye-strain, enlarged 
tonsils, adenoid growths at the back of the nose, and so 
forth, should receive prompt medical attention- 



CHAPTER XXXI. 

WHEN THE BABY GETS SICK. 



How to Tell When a Baby is 111: Its cry, cough, position, movements and 
gestures; grinding the teeth, difficulty in suckling; appearance of the face 
and head, chest, abdomen and tongue. The baby's temperature. How 
to take the temperature. The pulse in sick children. The breathing. The 
baby's bowel movements. The Management of Sick Children: Selection 
of the sick-room; ventilation, heating. The bed; articles needed in the sick- 
room; cleansing of the sick-room. The care of the sick patient. How the 
child should be dressed in bed. Feeding the sick child. Administering 
medicine to the child. Treating the throat. Administering a rectal injec- 
tion. Attention to the urine. 



"O Woman ! in our hours of ease 
Uncertain, coy, and hard to please ; 



When pain and anguish wring the brow, 
A ministering Angel thou !" 

— Scott. 

HOW TO TELL WHEN A BABY IS ILL. 



N infant is unable to express its thoughts and sensa- 
tions in words and can indicate its discomforts only 
by cries and movements. By examining the baby 
carefully and noting accurately its various symp- 
toms, one is able to tell when it is sick and often to locate 
the disease. 

The Baby's Cry. — From the character of the cry a great 
deal can be learned as to what ails an infant. A steady cry 
is usually due to hunger or to thirst, occasionally to ear-ache 
or to the pricking of a pin. The fact that the cry stops when 
the baby is nursed does not necessarily indicate that it is 
caused by hunger. If the crying comes in paroxysms or 

20 305 



306 WHEN THE BABY GETS SICK 

spells, being very violent for a time and then ceasing, it is 
probably due to colic. When a child cries every time it is 
touched it is usually a sign that the pressure causes pain. 
If the baby cries when the bowels are moved it shows that 
pain accompanies that operation; if when anything goes into 
the mouth, that there is some soreness there; and if upon 
swallowing, that the throat is inflamed. 

The Character of the Cough. — Much can be learned 
also from the character of the cough. In bronchitis the 
cough is frequent and loud, at first being tight and later 
loose. A very tight suppressed cough, followed by a grimace 
or by a cry, indicates some inflammation about the chest, 
often pneumonia. In spasmodic croup the cough is brassy 
and barking — the so-called croupy cough. 

The Position Assumed by the Child. — The position of 
the baby is a matter of importance. When an infant is 
feverish or in pain it is usually very restless, and wants to 
be taken up and put down again and carried about. When 
a child is exhausted by an illness, or by a severe acute dis- 
order, he lies upon his back. When he wants to be propped 
up with pillows, or to be held erect, or thrown over the 
mother's shoulder, it is usually a sign that breathing is in- 
terfered with. 

Movements and Gestures. — The seat of disease is often 
indicated by the little one's gesture. Babies frequently place 
their hands near the seat of pain. Picking at the nose is a 
frequent symptom in cases of intestinal worms. When the 
baby is about to have a convulsion he often draws the thumbs 
tightly into the palms of the hands and straightens or bends 
the toes stiffly. When suffering from colic an infant alter- 
nately doubles up and straightens out its body, squirms 
about and makes fists. Grinding of the teeth usually occurs 
when digestion is disturbed and sometimes when worms are 
present, or it may be only a nervous habit. 



WHEN THE BABY GETS SICK 307 

Difficulty in Suckling. — When a baby nurses only for 
a minute and then lets go of the nipple, there usually is some 
obstruction to breathing either in the nose or in the lungs. 
When it drops the nipple with a cry after getting a few 
sucks, its mouth probably is sore. If a baby swallows with 
a gurgling noise and takes as little food as possible, it doubt- 
less has a sore throat. 

Appearance of the Face and Head. — The color of the 
skin is often altered in disease, becoming pale, yellow or 
bluish. The face is swollen and flushed in whooping cough 
and measles, giving the child a heavy, stupid expression. It 
is puffy, especially about the eyes, in Bright's disease. When 
the system is drained by severe diarrhea the face becomes 
shriveled and wrinkled and the fontanelles depressed. 

Conformity of the Chest. — A glance at the chest will 
often aid In determining abnormal conditions. Knobs on 
the ribs, the so-called rachitic rosary, and a violin-shaped 
chest occur in rickets. When breathing is difficult there is a 
drawing in of the space between the ribs as the chest heaves. 

Appearance of the Abdomen. — The abdomen is hard 
and swollen in colic, in rickets and in chronic indigestion, 
but is usually much sunken in severe exhausting diarrhea 
and in inflammation of the brain. 

The Tongue. — Little can be learned from the tongue of 
an infant, as it is usually coated in all disturbances of the 
stomach and bowels, and in any disturbance accompanied 
by fever, while in severe inflammation of the bowels it may 
have a perfectly natural appearance. 

THE BABY'S TEMPERATURE. 

During the first week of life the temperature of the 
baby is about 99 , later settling down to the normal, 98.5 . 
Children's temperature rises at the slightest cause. Conse- 



308 WHEN THE BABY GETS SICK 

quently a high temperature in a child is a much less serious 
matter than when it occurs in an adult. Nevertheless a child 
with fever should always be put to bed and given a strict 
milk diet. It is usually safe to administer a dose of castor 
oil or calomel and even to give the child a hot bath. In every 
case, however, the physician must be sent for. One can 
never afford to take any risk. 

HOW TO TAKE THE TEMPERATURE. 

One who undertakes to nurse a sick person must know 
how to take the temperature. 

The Clinical Thermometer. — The amount of fever is 
measured by means of a small thermometer, which is pro- 
vided with what is known as an indestructible index; that 
is to say, the mercury rises when heated and then remains 
stationary until shaken down. 

Before the thermometer is used the mercury must be 
shaken down to a point below the normal mark. To do this 
requires some skill. The thermometer is grasped between 



The Clinical Thermometer. 

the thumb and the closed forefinger in a position parallel to 
the thumb and is swung downward with the motion used in 
ringing a bell. It should not be held as a pen and shaken up 
and down. 

Different Methods of Taking the Temperature. — The 
temperature may be taken by mouth, axilla or rectum. It is 
usually taken by the mouth in older children, the bulb of the 
thermometer being placed under the tongue and the lips be- 
ing tightly closed on it. 




THE ROYAL GERMAN FAMILY. 

To the German people of the fatherland and the world over t) 
family of comely children in the Emperor's home is a so 
gratification. The fatherland is safe as long as the home is pure. 



WHEN THE BABY GETS SICK 



309 



In young children and in unconscious patients the tem- 
perature is taken by the axilla. For this the thermometer 
and the arm-pit must both be perfectly dry. The bulb of the 
thermometer is inserted in the arm-pit and the arm is held 
tightly against the side. 

In infants the temperature is taken by the rectum, the 
thermometer being smeared with vaseline and then intro- 
duced. 

THE PULSE IN SICK CHILDREN. 

In an endeavor to find what the pulse-rate of a sick child 
should be at the different ages and with different degrees of 
fever, the author examined over 7000 cases and hospital 

records. After discarding 
all those cases in which 
owing to the nature of the 
disease the pulse is abnor- 
mally slow or abnormally 
rapid he calculated the 
average pulse-rate of the 
remainder. He found that 
when the temperature is 
normal, the pulse is 122 
from birth to the end of 
the second year, 114 from 
the second year to the end 
of the fifth year, 103 from 
the fifth year to the end of the ninth, and 89 from the ninth 
to the end of the twelfth year. For every degree the tem- 
perature rises, the pulse increases four to seven beats a min- 
ute, depending on the child's age. The pulse also increases 
with the slightest excitement, such as crying or even suck- 
ling. The author's investigation brought out a most inter- 
esting and surprising fact which proved that the statements 
in regard to a child's pulse as found in the text-books are 




Feeling the Pulse. 



310 WHEN THE BABY GETS SICK 

incorrect: i. e. s although with each degree of temperature 
the actual number of pulse-beats is greater the younger the 
child, the amount of increase is greater the older the child. 

A CHILD'S BREATHING. 

In the investigation of numerous records just men- 
tioned the author also endeavored to find what is the normal 
respiration-rate in children at different ages. When the 
temperature is normal an infant under two years of age 
breathes thirty times a minute, a child between two and five 
years breathes twenty-six times a minute, one between five 
and nine years twenty-five times a minute, one between nine 
and twelve twenty-four times. When a child becomes fever- 
ish it breathes more rapidly, the actual number of respira- 
tions as well as the amount of increase for each degree of 
temperature being greater the younger the child. For 
each degree the temperature is increased, infants under two 
years of age take 3 more breaths a minute; very young chil- 
dren between two and five years of age take 2\ more 
breaths a minute; children between five and nine years take 
2 more; and children between nine and twelve years of age 
take i\ more breaths a minute. When the child is debili- 
tated and poorly nourished and when it has some disease 
affecting the heart or lungs the breathing is much quicker 
than in the figures given. In meningitis, on the other 
hand, it is much slower. Marked irregularity in the breath- 
ing is an alarming symptom. Breathing through the mouth 
usually indicates enlargement of the tonsils or of the ade- 
noid tissue at the back of the nose. Labored or noisy 
breathing means that there is some obstruction in the throat, 
neck or lungs. 

THE BABY'S BOWEL MOVEMENTS. 
When the baby's digestion is disturbed, which* often 
may happen, a change occurs in the appearance of the 



WHEN THE BABY GETS SICK 811 

bowel movements. The color may vary from white to 
black, the latter occurring after the taking of certain medi- 
cine, such as bismuth and iron. If the passage is green, one 
should note whether it was that color when passed, it having 
already been stated that passages which were yellow when 
passed often turn to green on exposure to the air. When 
lumps of undigested milk appear in the stool, they indicate 
that the infant has not digested properly one or more 
ingredients of its food. A tough white curd is a sign that 
the baby is getting too much proteid; when the curd is yel- 
low and soft it means that he is getting too much fat. The 
percentage of the ingredient which is not being digested 
must then be reduced. 

THE MANAGEMENT OF SICK CHILDREN. 

The management of a sick child is a subject requiring 
both knowledge and skill. A trained nurse who has had 
experience with children will always be a great help when 
the baby falls ill. Yet as she usually tends her sick child 
herself, a mother should be familiar with the proper methods 
of nursing. In the management of sick children, gentleness, 
firmness, sympathy, truthfulness and tact are all necessary; 
and the child's confidence must be won. 

SELECTION, PREPARATION AND VENTILATION OF THE 

SICK-ROOM. 

The sick-room should be near the top of the house if the 
disease is contagious, but otherwise is more convenient when 
on a lower story. The room should be large and sunny, and 
should have a good-sized window or several windows open- 
ing top and bottom and working smoothly and easily, in the 
summer-time being protected from flies, mosquitoes and 
other insects by screens or mosquito netting. The floor is 
best covered with strips of old carpet which should subse- 






312 



WHEN THE BABY GETS SICK 



quently be burned. Where the carpet cannot be removed, 
it should be covered with linen. All unnecessary pictures, 
furniture and other objects should be removed. 

Ventilation. — The room should be well ventilated by 
means of windows. Draughts may be prevented by placing 
under the lower sash a board four to six inches wide, a carpet 
sack, or anything else that answers the purpose. Another 
method is to open either the lower or the upper sash, and 
cover the space thus made with a piece of paper, gauze, wire, 




Bed-rest. 

or flannel, in such a manner as to direct the air upward. A 
blind or an inside shutter may also prevent a draught. In 
addition the room should be thoroughly aired two or three 
times a day by opening all the windows top and bottom for 
a few minutes while the patient is covered up head and all or 
is removed into an adjoining room. 

Heating the Sick-Room. — The temperature of the sick- 
room should be kept at about 6o° Fahrenheit when the 
patient is in bed, and at about 65 Fahrenheit when he is up 
all day. It should always be tested by means of a ther- 
mometer. The best method of heating is by the open fire- 



WHEN THE BABY GETS SICK 



313 



place and grate. Stoves are not so good. When one is used 
moisture should be supplied by means of vessels of water 
placed on the stove or about the room. 



THE BED. 

The best and simplest bed is one made of brass or iron 
with a divided spring or a woven wire spring mattress. It 

should be accessible 
from both sides. The 
mattress should be fill- 
ed with straw, horse- 
hair or wire. Sheets 
of white bleached cot- 
ton are best, although 
in the summer-time 
linen may be used. 
The blankets and outer 
coverings should be 
light in weight. When 
in use the bed must not 
covered witfh a heavy 
cotton counterpane or 
The Bedside Table. down quilt, as its venti- 

lation is thereby interfered with. Two moderately firm 
horsehair pillows should be provided. The bed should be 
made with draw sheets as described in chapter XIX, on 
"Preparations for the Confinement." 




ARTICLES NEEDED IN SICK-ROOM. 

When a sick child sits up in bed his back should be sup- 
ported by a bed-rest or by a straight-backed chair placed 
behind the child in such a position that it rests on the front 
edge of its seat and on the top of its back. Sometimes it is 



314 



WHEN THE BABY GETS SICK 



necessary to keep tne weight of the bed clothes off the child 
by means of a bed-cradle, or by placing three half barrel 
hoops over the body at proper intervals, and tying the ends 
of these to the sides of the bed. Other articles needed in the 
sick-room would be a portable bed-board or bedside table, a 
screen, bed-pan and an urinal 



CLEANSING THE SICK-ROOM. 

The sick-room should be throughly cleansed, but in a 
manner that raises no dust. Everything used about the 
patient should be cleansed daily and once a week should be 
washed out with soap and water and then left standing in 
boiling water for an hour. 

How to Remove Stains. — Bed clothing, body clothing 
and other articles when stained, should be placed at once in 
a mixture of carbolic acid and soap prepared in the following 
manner: 

One and a half or two parts (ounces, pounds, whatever 
measure is used) of common soft soap are dissolved in one 




Bed-cradle. 



hundred parts of cold water, after which three parts of car- 
bolic acid are added, and the mixture is thoroughly stirred. 
After soaking in this mixture for half an hour or an hour the 



WHEN THE BABY GETS SICK 315 

clothes are removed and thoroughly rinsed in cold soapsuds 
until all traces of stains have disappeared. After this they 
may be washed in the regular way. Another method is to 
put the soiled articles into cold water for two hours and then 
boil them. 

To remove fresh blood stains from blankets or ticking 
a paste of fine starch or wheat flour is applied and allowed to 
dry. 

THE CARE OF THE PATIENT. 

The Sick Baby's Toilet. — Every night and morning 
the child's face, neck, hands, back and shoulders should be 
washed, the back and shoulders being then rubbed with al- 
cohol and dusted with an absorbent powder. During the 
day a warm general bath should be given, special attention 
being paid to the arm-pits, feet and legs. The mouth should 
be rinsed and swabbed at least three times a day, in some 
cases every hour. This may be done with a small tooth 
brush, or small squares of gauze or old muslin wrapped 
around the index finger. 

Cleansing the Hair. — If the hair contains nits or para- 
sites it may be cut close or even shaved, or it may be treated 
in one of the following manners: 

The head is bound up for two or three days in a cloth 
kept moistened with a five per cent, solution of carbolic acid, 
or a solution of bichlorid of mercury in the proportion of 
one grain to the ounce, or a decoction or alcoholic solution 
of larkspur. Over this a cap of oiled muslin is placed, the 
pillow being protected by a rubber cloth. Another method 
is to mix equal parts of kerosene oil and olive oil and rub 
this mixture well into the scalp at night, the head being then 
tied up with a piece of muslin. When this is removed the 
head should be thoroughly dried, and, if desirable, alcohol 
may be rubbed in along the roots. Any of these methods 



316 WHEN THE BABY GETS SICK 

will destroy both parasites and nits. The latter, however, 
are very difficult to remove. Their connection with the hair 
is dissolved with vinegar, which may be rubbed in the hair 
or applied on a cloth. A fine comb will then easily remove 
them. 

HOW THE CHILD SHOULD BE DRESSED IN BED. 

A baby confined to its bed should wear merely a night 
dress, having one for the day and another for the night, but 
when it is propped up in bed it should wear a light sack. 
Whenever the child is taken out of the bed, if only for a 
moment, a wrap should be thrown about it. 

FEEDING THE SICK CHILD. 

In feeding a sick child, it is well to regard his appetite, 
his likes and dislikes, his whims and fancies, his digestive 
ability, the time when he is most faint or hungry, and the 
quantity he usually can eat. The food must be carefully pre- 
pared and served in a dainty manner. When a child is easily 
satisfied, instead of forcing the food, it might be better to 
feed more frequently and give less at a time. The child will 
usually drink all of a small glass of milk when if the glass 
be large it will take much less or none. 

Character of the Food. — The food must be fresh and in 
perfect condition and properly cooked and seasoned when 

served. Hot food should 
always be served hot, not 
luke-warm, and cold food 
should always be served 
cold. When milk dis- 
agrees or is distasteful it 

Feeding Cup. ° , , #1 

may be diluted with plain 
or carbonated water or made alkaline by the addition of lime 
water or baking soda, the latter in the proportion of ten 




\ 



WHEN THE BABY GETS SICK 



31? 



grains to the pint, or a pinch of salt, a little sugar, a little 
cocoa or extract of vanilla may be added. As a rule the child 
should be given plenty of water, which must first be filtered 
and boiled. 

ADMINISTERING FOOD TO THE SICK CHILD. 

The child should be fed regularly, and should be al- 
lowed sufficient time to eat in a leisurely manner. He should 

be assisted when necessary, and 
entertained with interesting and 
cheerful conversation. When the 
child is helpless, the nurse places 
her hand beneath the pillow and 
raises the head slowly and gent- 
ly, keeping it straight so as to 
prevent the food coming out of 
the side of the mouth, but not 
bending it so far forward as to 
make swallowing difficult. The 
child should be fed with a medi- 
cine cup or tumbler, which 
should never be more than half 
full, with a glass or china feeding 
cup, a spoon, a medicine dropper, 
a nursing bottle, or through a 
glass or rubber tube. One 
mouthful must be disposed of be- 
fore the next is given. 
Feeding an Unconscious Child. — An unconscious child 
should not be given more than one teaspoonful or less than 
half a teaspoonful at a time. The spoon should be placed far 
back in the mouth, emptied slowly and withdrawn, the lips 
and nostrils being then held shut. The nurse must see the 
child swallow before she repeats the process. The medicine 
dropper should be inserted between the cheek and teeth as 
far back as possible, and then emptied. It should not be 




Combination 
Feeding and Drinking Cup. 



318 



WHEN THE BABY GETS SICK 



placed between the teeth, as it might be bitten. Another 
method is to pour fluids with a spoon or medicine dropper 
into the nostril. 



ADMINISTERING MEDICINE TO THE CHILD. 

When the child has not been trained in habits of 
obedience, the giving of medicine is often rendered very 
difficult. Persuasion should first be tried, honest bribery 
being permitted, such as the promise of chocolate or other 
sweet, a penny, or some simple toy. If the child should re- 
main obstinate, it is best to 
waste no further time in 
argument or pleading. The 
nurse should take up the 
child, wrap a shawl or sheet 
closely around its body and 
arms to prevent interference, 
hold the nose carefully and 
when the mouth is opened 
insert the spoon or medicine 
dropper in the manner just 
described. If this is done 
without excitement or anger, but with great firmness and 
as a matter of course, it may not often have to be repeated, 
as the child will learn to regard it as inevitable and in con- 
sequence will often take the medicine quietly. 

Giving Medicine to an Infant. — To make a young baby 
open its mouth, one should press backward and downward 
on the chin with the finger. When an infant spits out the 
greater part of a teaspoonful of medicine the dose should be 
given a little at a time. It may then be taken very well. 

Avoidance of Deceit. — The child must not be deceived. 
It should never be told that a disagreeable medicine does 




Feeding a Patient in the 
Recumbent Position. 



WHEN THE BABY GETS SICK 



319 



not taste bad or that the dose is to be the last when such is 
not the case. 






Minim Glass. 



Graduated Medicine Glasses. 



How to Give Medicines to a Child. — The bad taste of a 
liquid medicine may be avoided to some extent if the dose be 
immediately preceded and followed by a sip of water, a mint 
drop or the suck of an orange. When liquid medicines are 
given, they had better be measured by means of a medicine 
glass, as teaspoons vary greatly in size, and it is impossible 
to determine just when they are exactly full. An oil should 
be given from a spoon previously heated in hot water. Pow- 
ders are best placed directly on the tongue and washed down 
with a sip of water. They may be mixed with a little sugar 
and taken in the same way, or a small quantity of sugar may 
be put in a teaspoon, the powder emptied on it evenly, and 
the spoon rilled with sugar, the whole then being stirred. 
Powders may also be stirred up thoroughly in a little jam or 
scraped apple if this is allowed. Tasteless powders may 
often be given in bread and milk or milk toast without the 
child noticing it. 

Pills cannot be taken by very young children, but if 
placed within a little jelly or preserved fruit can often be 
taken by older children. The child may first practise with 
bread pills until it is able to swallow them easily. 



320 WHEN THE BABY GETS SICK 

TREATING THE CHILD'S NOSE. 

The throat is sprayed with an atomizer, the tongue be- 
ing well depressed so that the solution reaches the throat. 




Spray Apparatus or Atomizer. 



When the nurse has to make an application to the child's 
throat, she should wrap the child in a shawl and hold it so 



WHEN THE BABY GETS SICK 321 

that it faces a bright light. With a spoon in one hand, and 
a large, straight earners hair brush, firmly fastened to a 
straight, stout stick, in the other, the nurse takes her posi- 
tion opposite the child. Carefully inserting the handle of 
the spoon between the teeth she gradually and gently works 
it inward. As the back of the tongue is reached the child 
gags and opens its mouth widely. At that moment with the 
brush moistened in the solution, she rapidly and thoroughly 
paints the throat. 

Local Applications of Heat and Cold. — The various 
methods of applying cold, and dry or moist heat locally are 
given in chapter XXXIII. 

ADMINISTERING A RECTAL INJECTION TO A CHILD. 

In giving an enema to the child one may use an infant's 
syringe, consisting of a soft rubber bulb with a hard rubber 
nozzle, or an ordinary hard rubber syringe holding four to 
six ounces and fitted with a piston which moves easily. The 
bed should be protected by a rubber sheet and a folded 
sheet or towel. The patient lies on his left side near the 
edge of the bed with his hips and knees flexed. After the 
fluid has been drawn into the syringe, the nozzle is well 
oiled or greased with vaseline and gently inserted into the 
rectum upward, backward and to the left. No force must 
be used or the rectum may be perforated. The fluid is in- 
jected very slowly and should be retained for ten or fifteen 
minutes. To aid in this retention, the nozzle is gently re- 
moved and a folded towel is pressed against the anus. Some- 
times in cases of inflammation of the bowels it is necessary 
to give a large injection. For this a fountain syringe may be 
used, or a long rubber tube fitted with a funnel at one end 
and a catheter at the other, or an ordinary elastic bulb 
syringe, although this last is not so desirable. The child 

21 



822 WHEN THE BABY GETS SICK 

should lie upon its back or on its left side for this injection, 
which should be given very slowly. Wrapping a narrow 
roller bandage firmly around the nozzle of the syringe will 
help to prevent the fluid from being ejected while the injec- 
tion is being given. To help the child in retaining the injec- 
tion the nurse may hold the cheeks of the buttocks together 
or apply pressure with a clean towel laid against the anus. 

ATTENTION TO THE URINE. 

The urine must always be measured and an accurate 
record kept of the amount voided in the twenty-four hours. 

When a patient has gone as long as six hours without 
passing water, means must be taken to excite urination. 
Hot applications may be made over the loins, lower portion 
of abdomen, and external genitals. A hot sponge may be 
placed between the thighs, or a bed-pan containing steaming 
water inserted beneath the hips. The sound of running 
water will sometimes stimulate the bladder to act. Cathe- 
terization should be performed only by a physician or 
trained nurse and with surgical cleanliness or asepsis. 



CHAPTER XXXII. 

THE COMMON AFFECTIONS OF INFANCY 
AND CHILDHOOD. 



The Highly Contagious Diseases: Measles, rubella, scarlet fever, diphtheria, 
membranous croup, small-pox. The management of a highly contagious 
disease. Isolation: Preparation of the room; method of disinfecting the 
linen, hands, dishes, vessels, urine and feces; the nurse's attire; care of 
the food; frequent disinfection; disinfecting the mouth and nose; conva- 
lescence; disinfecting the sick-room; disinfecting the bedding and cloth- 
ing; disinfecting a privy, etc. Care of the body after death. Quarantine. 
The Management of the Mildly Contagious Diseases: Chicken-pox, whoop- 
ing-cough, typhoid fever, consumption. The Intestinal Disorders of In- 
fancy. 



"Good Christian people, here lies for you an inestimable loan; 
take all heed thereof, and in all carefulness employ it, with high recom- 
pense ; or else, with heavy penalty, will it one day be required back." 

— Carlyle. 



HO attempt is made in this book to teach the diagnosis 
and treatment of all the diseases of infancy and 
childhood. A woman need not suppose that with a 
few minutes reading she can obtain the knowledge 
that a medical man must spend years in acquiring. When- 
ever a child is sick the mother should send for a physician. 
Valuable time is often lost by waiting too long. 

It is nevertheless necessary for every mother to know 
how to tend a child when it is sick. Consequently in this 
chapter precise and definite instructions are given as to the 
management of sick children when suffering from any of the 
common affections to which they are subject. 

323 



324 THE COMMON AFFECTIONS 

From the standpoint of nursing, children's diseases 
may be divided into certain groups. The author has classi- 
fied them as the highly contagious diseases, the mildly con- 
tagious diseases, and the digestive disorders. The manage- 
ment of the particular disease depends altogether upon the 
group to which it belongs. Strict isolation, for instance, is 
necessary in the first group but not in the others. 

THE HIGHLY CONTAGIOUS DISEASES. 

Nature of the Highly Contagious Diseases. — Measles, 
rubella or German measles, scarlet fever, diphtheria and 
membranous croup, and small-pox are highly contagious dis- 
eases, communicated directly from one person to another, 
or from clothing, rags, and the like, which have been in con- 
tact with the sick person, or from the various discharges — 
sputum, urine and bowel passages — of a person sick with the 
disease. Insects and domestic animals may also carry con- 
tagion. 

Measles is the most frequent and the most contagious 
disease known. Prominent symptoms are a heavy, stupid 
expression, running of the eyes and nose, inability to stand 
the light, cough, and a typical rash. When such symptoms 
occur the child should be isolated and a physician sent for. 
It is an error to regard measles as a disease of little conse- 
quence. Thousands of cases every year prove fatal, in many 
instances through a complicating pneumonia or consump- 
tion. 

Rubella, popularly known as German measles, is a 
mild affection in which the rash is the most pronounced 
symptom. 

Scarlet fever is usually attended with a scarlet eruption 
of the skin, and is generally accompanied by a sore throat. 
When a child has a sore throat and a fever, especially if ac- 
companied with an eruption on the skin, it should be imme- 



THE COMMON AFFECTIONS 325 

diately separated and kept secluded from all persons, except- 
ing one necessary attendant, until a physician has deter- 
mined that such isolation is unnecessary. 

Diphtheria may affect the nose, the upper or back part 
of the throat, and the lower part of the throat, or larynx. 
This last condition is known as membranous croup. When a 
child has a sore throat showing even a small whitish spot, 
has a bad odor to its breath, and especially if it has fever, 
it should be immediately isolated until seen by a physician. 

Small-pox can be so easily prevented by such a simple 
means as vaccination (see page 333) that it should never ap- 
pear in a civilized community; a consideration of its symp- 
toms therefore is mere waste of time. 

THE MANAGEMENT OF A HIGHLY CONTAGIOUS DISEASE. 

No matter what the method of treatment adopted in 
scarlet fever, diphtheria and small-pox, the principal feature 
of the nursing is prompt and thorough isolation of the 
patient during the continuance of the illness, and thorough 
disinfection after the patient has recovered. The same pre- 
caution should be adopted in cases of measles, but may be 
modified for rubella. 

Isolation. — By thorough isolation is meant the seclusion 
of the patient in such a manner that the danger of transmit- 
ting his disease to others is reduced to the lowest practicable 
point. The only persons to enter the room should be the 
physician and the nurse, and neither should leave the room 
without being first thoroughly disinfected. Placing the 
patient in a room by himself would by no means be sufficient 
to prevent contagion if articles and persons with which he 
comes in immediate contact were allowed to circulate 
through the house. 

Abbott says that "isolation means more than merely 
confining the patient to a separate room or building. It com- 



326 THE COMMON AFFECTIONS 

prises in addition to this the employment of a separate at- 
tendant who comes in contact only with the patient or 
patients for whom he or she is employed to care; the disin- 
fection of all infected matters as soon as they are passed 
from the patient, and before they leave the sick-room; the 
disinfection of all bed and body-clothing as soon as they are 
removed from the patient, and before they leave his apart- 
ment; the provision of separate eating utensils, handker- 
chiefs, towels, napkins, clinical thermometers, tongue de- 
pressor and other instrumental accessories; the frequent 
cleansing with disinfecting solutions of the sick-room and 
its furniture; the frequent general bathing of the nurse; and 
especially the careful disinfection of the hands after each 
manipulation of the patient." 

Preparation of the Room. — The patient should be 
placed in a room prepared as described in the preceding 
chapter. Screens should be placed in the windows to keep 
out flies and other insects which may help to disseminate 
the disease. A sheet kept continually wet with a one per 
cent, solution of formalin, a five per cent, solution of carbolic 
acid, or, safest, a solution of chloride of lime* — one-half 
pound of chloride of lime to a pail of cold water, should be 
hung outside of the door. The sheet is kept wet by being 
sprayed or sprinkled with the solution, or by being im- 
mersed in it from time to time. 

Method of Disinfecting the Linen.— A large vessel, such 
as a tub, containing a solution consisting of carbolic acid 
three parts, common soft soap two parts and water one hun- 
dred parts, and kept covered, if possible, should always 
stand in the room. When the bed and body linen are soiled 
by evacuations, secretions, or excretions, the tub is brought 
to the bedside and the clothes are removed with as little agi- 



*This is the popular name for chlorinated lime. The two terms are used 
interchangeably in this chapter. 



THE COMMON AFFECTIONS 327 

tation and commotion as possible and at once immersed into 
the solution. As soon as they are thoroughly saturated the 
cover is replaced and they are allowed to soak for two hours. 
The cold carbolic-soap solution not only disinfects but dis- 
solves out all stains as well. The clothes should then be 
wrung out and placed in a receptacle such as a bucket stand- 
ing outside the door and may then be carried to the laundry 
without danger. 

Whenever possible, one should provide a small gas stove 
and a wash boiler of about four gallons capacity into which 
all small infected articles, such as napkins, handkerchiefs, 
towels and the like, should be immersed, to be steamed or 
boiled in water or soda solution before they are sent to the 
laundry. Where this cannot be obtained the small articles 
should be placed in the tub in the carbolic-soap solution. 

Dishes and Vessels. — All glasses, cups and other ves- 
sels used by or about the patient should be boiled or placed 
in a solution of chloride of lime before being removed from 
the room. 

Disinfection of the Urine and Feces.— The urine and the 
bowel discharges should be received into vessels containing 
a solution of four fluid ounces of carbolic acid to the gallon 
of water, or of four ounces of the best chlorinated lime to the 
gallon of water. The vessel should be covered, and the dis- 
charge allowed to remain in contact with the disinfectant 
for at least half an hour before being thrown out. These 
evacuations may also be disinfected in the manner described 
later in this chapter in connection with typhoid fever. 

Receptacle for the Sputum. — A spit-cup, such as de- 
scribed on page 339, or a basin containing chlorinated lime 
or a five per cent, solution of carbolic acid, or some other 
efficient disinfectant, should be kept constantly at the 
patient's side for him to spit into. 



328 THE COMMON AFFECTIONS 

Care of the Food. — Food for both the patient and the 
nurse should be placed outside the door whence it may be 
taken into the room by the nurse. All eating utensils should 
be placed in a chloride of lime solution after being used. 
What is left from the meal should be thrown into a covered 
receptacle containing milk of lime or the solution of chlor- 
inated lime. Milk of lime is made by slaking a quart of finely 
divided, fresh formed lime in one quart of water, then adding 
three quarts of water and stirring the mass thoroughly. 

Disinfection of the Hands. — There should always be 
ready and convenient a basin containing a solution of chlor- 
ide of lime — one-half pound of chloride of lime to a pail of 
cold water, of chlorinated soda in the proportion of two 
fluid ounces to the quart of water, or of formalin in the 
strength of I to 500, another basin containing plain water, 
and a good supply of towels, so that the hands of the nurse 
may be disinfected and then scrubbed with soap and water 
immediately after having been brought into contact with 
the patient. 

The Nurse's Attire. — The patient and the nurse should 
remain in the sick-room and must not come in contact with 
anyone else in the house. It is advisable for the nurse while 
in the room to wear a cap which completely covers her hair, 
a long gown which reaches from her neck to the tops of her 
shoes and covers her dress completely, and loosely fitting 
carpet overshoes. Before leaving the room the nurse should 
remove her cap, gown and overshoes and, after disinfecting 
her hands in the chloride of lime solution, wash her face, 
neck and hands with soap and water. She should leave her 
gown and overshoes near the door so that she can put them 
on as soon as she enters again. When passing through the 
house to take out-door exercise she should go straight out 
without stopping. 



THE COMMON AFFECTIONS 329 

Frequent Disinfection. — At least every second day the 
floor and all horizontal surfaces, such as window-sills, man- 
tels, furniture, knobs of doors, etc., should be wiped with 
cloths moistened with a three per cent, solution of carbolic 
acid or the chloride of lime solution described. Instru- 
ments such as tongue depressors and clinical thermometers 
which may frequently be required should be kept in a disin- 
fectant solution of chloride of lime or I to 20 carbolic acid. 

Disinfecting the Mouth and Nose. — As the discharge 
from the nose and mouth is contagious in this group of dis- 
eases, the nose and mouth of both patient and nurse should 
be sprayed with a disinfectant solution, each, of course, 
using a different atomizer. The best spray for the throat is 
a solution of formalin one to five hundred; for the nose a 
milder disinfectant must be used, such as phenol sodique, 
glyco-thymoline and similar preparations. Pocket handker- 
chiefs should not be used, but small pieces of muslin should 
be employed instead for wiping the mouth and nose. These 
pieces after once being used should immediately be burned. 

Care of the Body. — The patient's skin should be bathed 
frequently with a weak alcoholic or with a mildly disinfect- 
ant solution. In diseases such as scarlet feaver and measles, 
where there is scaling, the skin should be greased with olive 
oil or sweet oil, carbolated vaseline, cocoa butter, benzoin, 
or carbolated lard, etc., to prevent the particles from enter- 
ing the air. 

The nurse should avoid as much as possible going too 
close to the patient, especially avoiding hanging over the bed. 

Convalescence. — The isolation should be continued un- 
til all danger from contagion is passed. In diseases asso- 
ciated with a rash this danger is not over until desquama- 
tion is completed and there is no sign of scaling on any part 
of the body. A diphtheria patient cannot be allowed out un- 
til several bacteriological examinations of the nose and 



830 



THE COMMON AFFECTIONS 



mouth show that there are no diphtheria germs present 
there. 

Removal from Isolation. — Before the child is removed 
from the sick-room it must have a disinfecting bath in a solu- 
tion of bichlorid of mercury in the strength of I to 4000. 
The child may be sponged with this solution or be immersed 
in a bath tub. It is then dried with towels which have never 
been in the sick-room, removed to another room and dressed 
in clothing which has not been in the sick-room or has since 
been disinfected. 

DISINFECTING THE ROOM. 

The Different Methods of Disinfection. — A room may 
be disinfected in various ways : by spraying a solution of 
formalin; generating formaldehyde gas from its watery solu- 
tion, from methyl-alcohol, or from 
solid tablets of polymerized formal- 
dehyde; and generating sulphur 
dioxide by burning brimstone or 
prepared sulphur candles. For 
each one thousand cubic feet of air 
space to be disinfected, one pound 
of formalin, one quart of methyl- 
alcohol, fifty to seventy-five solid 
tablets of polymerized formalde- 
hyde or three pounds of sulphur 
should be used. The most effective 
method is that of spraying a solu- 
tion of formaldehyde, a procedure 
that can be carried on only by an 
experienced person. It is the 
method that has been adopted by 
the Board of Health of Philadel- 
phia as being the most satisfactory. 
In the large cities the Board of Health usually will undertake 
the disinfecting of a room free of charge. Sulphur destroys 
germs only when acting on moist objects, and is of little value. 




THE COMMON AFFECTIONS 331 

How to Disinfect a Room. — If an apparatus generating 
formaldehyde gas is used it may be placed in the center of the 
room and ignited. There is an improved apparatus by which 
formaldehyde gas may be generated from its watery solu- 
tion outside of the room and introduced by means of a tube 
thrust through the key-hole. When sulphur is employed it 
should be used in the form of powder or in small pieces 
which should be placed in a shallow iron pan set upon a 
couple of boards in a tub partly filled with water. The sul- 
phur should be moistened with alcohol before it is set on fire. 

The windows should then be fastened, the doors locked, 
and the crevices and key-holes sealed by sticking adhesive 
paper over them, or by plugging them with rags or papers. 
The room should remain closed for six hours, after which it 
should be well aired for several days, the doors and windows 
being thrown wide open. 

Airing and Cleansing after Disinfection. — As soon as 
the fumes have disappeared so that a person can remain in 
the room comfortably, the ceiling, walls and all horizontal 
surfaces, such as window-sills and mantels, should be wiped 
thoroughly with cloths wrung out of a four per cent, soda 
solution, or of a fresh solution of chloride of lime. The floor 
is then to be scrubbed with a four per cent, soda solu- 
tion. All hangings, curtains and carpets which have re- 
mained in the room should be removed after disinfection 
and thoroughly beaten or shaken on an open lot and then 
freely exposed to direct sunlight. It is better to remove the 
wall paper after moistening it with a soda solution. 

After the room has been disinfected and cleaned it 
should be thoroughly aired for a few days before it is again 
occupied. 

When Complete Isolation is Impossible. — When in the 
more serious diseases such as scarlet fever or diphtheria it 
is impossible to practice perfect isolation, it is better to send 



332 THE COMMON AFFECTIONS 

the child to a hospital, especially if there are other children 
in the house. If, however, a mother insists upon tending 
the sick child and also coming in contact with the well mem- 
bers of the family, she should be careful to wear the cap and 
gown while in the sick-room and to disinfect herself thor- 
oughly before she leaves the room. 

Thorough disinfection, however, is always possible. 
Anything less is foolish, furnishing no protection, while 
giving a false sense of security. 

DISINFECTING THE BEDDING AND CLOTHING. 

The City Disinfection Station. — Steam is the best disin- 
fectant for clothing. Many of the larger cities have a munici- 
pal disinfection station, under the management of the Board 
of Health, where articles may be disinfected by steam free 
of charge. The bedding and clothing should remain in the 
room while it is being disinfected and afterwards should be 
packed in a tightly closing canvas bag and conveyed to the 
disinfection station. 

Disinfecting Clothes at Home. — Spraying the clothes, 
however, with a strong solution of formaldehyde is an effi- 
cient means of disinfecting them. They should be sprayed 
when the room is being disinfected, and remain in the room 
while it is closed up. Another method is to hang the clothes 
loosely in a closet, and generate the vapors of formaldehyde 
by burning a lamp for decomposition of solid tablets of 
polymerized formaldehyde, which should be used in the pro- 
portion of seventy-five for every one thousand cubic feet of 
air space in the closet. The door of the closet must be kept 
closed and sealed while the formaldehyde is being generated, 
and should remain so for twenty-four hours afterward. 

Boiling for at least half an hour is one of the surest ways 
of disinfecting contaminated clothing. 




PREPARING DAINTY DISHES. 

It is woman's pride to skilfully and intelligently prepare healthful 
food, and such as is adapted to the needs of her family. She should be 
familiar with the principles of cooking as given by an authority. 



A 



THE COMMON AFFECTIONS 333 

Care of the Body After Death. — When a child has died 
of scarlet fever, diphtheria or small-pox its body should be 
at once wrapped in a sheet saturated with a five per cent, 
solution of carbolic acid or a chloride of lime solution or 
a one to one thousand corrosive sublimate, or a four per cent, 
formaldehyde solution, and immediately placed in its coffin 
or casket which is then closed. Burial or cremation should 
occur as soon as practicable. In most States the law forbids 
public funerals in these cases. 

DISINFECTING A PRIVY, CESSPOOL, ETC. 

After any contagious disease has occurred, the privy 
vault or cesspool should be disinfected, two and a half 
pounds of chlorinated lime being used for every eight gal- 
lons, or about one cubic foot, of fecal matter contained in 
the vault. The disinfectant should be dissolved and applied 
in solution so as to mix better with the fecal matter. 

THE ESTABLISHMENT OF QUARANTINE. 

Small-pox is such a highly contagious disease, and so 
dangerous to a community in many ways, that in addition to 
isolation the establishment of a quarantine is usually neces- 
sary. When a house is quarantined no one is allowed to en- 
ter or leave it. As a rule, an officer of the law is stationed 
at the doors to prevent any communication between the peo- 
ple in the house and those outside. The quarantine is usually 
maintained until all danger of the occupants of the house 
contracting the disease has passed. Small-pox, however, is 
an absolutely preventable disease, a successful vaccination 
protecting the individual from attack for a period of not less 
than four years. 

VACCINATION. 

Vaccination an Absolute Preventative of Small-pox. — 
No one has ever taken small-pox within four years of a suc- 
cessful vaccination. During the epidemic of 1 901-1902, seven- 



334 THE COMMON AFFECTIONS 

teen hundred small-pox patients were treated at the Munici- 
pal Hospital, Philadelphia. Not one of these had been suc- 
cessfully vaccinated within four years. In this same hos- 
pital are physicians, nurses and attendants who come in 
close contact with the most virulent cases of small-pox. 
Women scrub the wards, wash the patients' dishes, and their 
bed and body-clothes. Not one has ever contracted the dis- 
ease, because all had been recently vaccinated successfully. 

In 1875 a law was introduced in Germany commanding 
vaccination at birth, and at the tenth year. From 1816 to 
1870 out of every 100,000 people in Prussia, eight to sixty- 
six died of small-pox every year. In 1871, two hundred and 
forty-three, and in 1872, two hundred and sixty-three died 
out of every 100,000. Between 1875, when the law was 
passed, and 1886, the average number of deaths for every 
100,000 of the population was a little less than two. 

When a Person Should be Vaccinated. — A person 
should be vaccinated in infancy, and about every ten years 
after that. During an epidemic no one should go longer 
than four years without being re-vaccinated. 

No Danger from a Properly Performed Vaccination. — 
There is little danger from a vaccination if it is performed in 
a proper manner and is carefully attended to afterwards. 

The Best Time for Vaccination. — The best time to vac- 
cinate an infant is when it is four or five months old. If the 
vaccination is performed between the sixth and twentieth 
months, it should not be done while the child is teething, nor 
at a time when the food is being changed, nor when the child 
is suffering from any disease. The outside of the upper arm 
is the usual place for vaccination, but in girls the outside of 
the leg just below the knee is sometimes considered more 
desirable. When exposed to small-pox one must be vacci- 
nated immediately. 



THE COMMON AFFECTIONS 335 

Method of Vaccination. — The surface of the skin should 
be thoroughly cleansed with soap and water, and then with 
alcohol. Chemical disinfectants should not be used, as they 
interfere with the action of the virus. After the vaccination 
has been performed, the virus should be allowed to dry for a 
few minutes. The part should then be protected by a simple 
gauze dressing kept in place by strips of adhesive plaster, by 
a new bandage, or by a piece of muslin which has been ster- 
ilized. Shields are not desirable. Every day until the vac- 
cination wound has healed the dressing should be removed 
and the part washed with soap and water and then with a 
disinfectant solution, after which a fresh dressing should be 
applied. 

THE MILDLY CONTAGIOUS DISEASES. 

Chicken-pox, whooping-cough, mumps, typhoid fever, 
and consumption may be regarded as the mildly contagious 
affections. The diseases included in this group are all com- 
municable; they are caught by one person from another. 
Not all, however, are carried by the air or by a third per- 
son. The contagion resides in the sputum or saliva or in 
the bowel evacuations. Consequently the management dif- 
fers somewhat from that of the diseases just studied. 

CHICKEN-POX. 

Chicken-pox is the mildest of all the contagious dis- 
eases and seldom has an unfavorable termination. As the 
disease is contagious the child should be kept away from 
other children until all traces of the disease have disap- 
peared. It should be confined to the house, put upon a milk 
diet, and carefully watched to prevent scratching or picking 
at the spots. As a rule, no other treatment is required. As 
other diseases are frequently mistaken for chicken-pox, a 
doctor should be called in whenever the child presents a 
suspicious eruption. 



836 THE COMMON AFFECTIONS 

In no case, however mild, must the patient mingle with 
other children within two weeks of the date of onset. 

WHOOPING-COUGH. 

Whooping-cough is a more serious disease than is gen- 
erally supposed, especially in young infants and in children 
who are debilitated or poorly cared for. Many children die 
from its effects, pneumonia and consumption being the most 
frequent complications. It is a contagious disease, commu- 
nicated directly from one person to another. 

The Symptoms of Whooping-cough. — The disease be- 
gins as a cough, which gradually gets worse, after a period 
averaging two weeks occurring in paroxysms. The child 
gives a number of short, spasmodic coughs, rapidly repeated 
without drawing the breath, and continued until it is nearly 
blue and its eyes protrude. It then makes a long-drawn in- 
spiration with a peculiar loud crowing sound, called a 
whoop. These paroxysms are often followed by vomiting, 
and usually by the expulsion of a large amount of stringy 
mucus. The stage of this paroxysmal cough and whoop 
commonly lasts from three to four weeks or even longer. 
The cough then becomes looser, the paroxysms less severe, 
and the whoop less frequent, ceasing entirely after three or 
four weeks. 

Management of a Child with Whooping-cough. — The 
child should be kept away from other children during the 
whole course of the disease. When the whoop distinctly 
ceases over a period of some days, the disease may be said to 
be over, although the whoop may later begin again, as a sort 
of habit. A physician should always be consulted on ac- 
count of the seriousness of the disease and the dangers of its 
complications. The child should have plenty of fresh air 
without being exposed to draughts and should be warmly 
clothed. It must remain away from public gatherings. 

An infant with whooping-cough ought never be left 



THE COMMON AFFECTIONS 337 

alone. It must always be taken up when a paroxysm is ap- 
proaching. During the paroxysm the infant should be held 
in different positions, and at the end its head and body 
should be bent forward so as to aid in the expulsion of the 
tenacious mucus. At times if the finger, covered with a 
clean cotton cloth, be quickly introduced into the throat it 
may withdraw the mucus in this way, being then disinfected. 
A change of air, either at the country or at the seashore, 
may be of benefit in protracted cases. 

MUMPS. 

Mumps is a contagious disease, characterized by in- 
flammation and swelling of the gland that is situated in 
front of and behind the ear, and sometimes of a gland below 
the jaw. The attack lasts from a few days to a week. The 
period of contagion, however, lasts much longer. The child 
should be isolated or kept away from other children for at 
least three weeks from the onset of the disease or, in pro- 
longed cases, until ten days or two weeks have elapsed after 
the disappearance of the swelling. 

TYPHOID FEVER. 

How Typhoid Fever is Communicated. — Typhoid fever 
is not, strictly speaking, a contagious disease but it is com- 
municable, the infection occurring by way of the digestive 
tract. There is only one manner in which typhoid fever is 
transmitted: by swallowing materials that have come di- 
rectly or indirectly in contact with the bowels of individuals 
affected with the disease. The disease is carried by means of 
water, green vegetables — as lettuce and celery, and oysters, 
etc., which have become contaminated by the discharges of a 
typhoid fever patient. Hands that have come in contact with 
such a patient, with infected body linen, or with anything 
else soiled by discharges of a typhoid fever patient, may 

22 



838 THE COMMON AFFECTIONS 

carry the disease indirectly by infecting the food that they 
touch, especially in handling milk at the dairy or in the 
kitchen. The disease is also carried by flies, which pass from 
the discharges to the food. 

Care of a Typhoid Fever Patient. — The proper care of 
a typhoid fever patient is the most important factor in the 
prevention of the spread of the disease. This is accom- 
plished by prompt disinfection of all discharges from the 
patient. The bowel evacuations should be mixed with 
double their volume of chloride of lime, of milk of lime or of 
boiling water or of a boiling two per cent, soda solution. The 
vessel should then be covered and allowed to stand for from 
one to two hours before being emptied. All bed and body 
clothing, all napkins and towels used about the patient, and 
all eating utensils should be disinfected according to the 
method previously described. (See pages 326 and 327.) 
Stains may be removed as directed on page 314. All value- 
less articles used about the patient should be immediately 
burned. After attending to the patient the nurse should im- 
merse her hands for several minutes in a disinfectant solu- 
tion, and then scrub them thoroughly with warm water, 
soap and a nail brush. 

CONSUMPTION OR TUBERCULOSIS. 

Care of the Sputum. — In diseases such as consumption 
(and also pneumonia), in which the sputum is contagious, 
the child should expectorate into a suitable vessel containing 
9 disinfectant solution of carbolic acid or chlorinated lime 
-and kept covered to keep out insects. The child may have 
his individual sputum cup, which is best made out of metal 
so it cannot break. The sputum should be destroyed by 
boiling for twenty minutes in a solution of one ounce of 
washing soda to a pint of water or by the addition of a tea- 
spoonful of ordinary wood vinegar to each ounce of sputum. 



THE COMMON AFFECTIONS 



339 



Paper cups may be used which can be destroyed by fire. Dr. 
Knopf has devised a sputum flask which can be carried in 
the pocket. A pasteboard cup in a metal holder or a tin cup 
into which a newspaper has been folded all around may be 





Ordinary Spit Cup. 




Pocket Sputum Flask. 



Sanitary Spit Cup. 
This is made of pressed paper, 
with cover and handle, and is de- 
stroyed by burning. 



used, the paper being frequently removed and burned. If 
found more desirable, the child may expectorate into cloths 
or Japanese paper napkins. These must be promptly burned 
or placed in a muslin or paper bag, which is later to be 
burned with its contents. The patient should never spit 
into a handkerchief or towel which is to be washed and 
used again. 

The Life of a Consumptive. — In order to guard against 
contagion a consumptive should never kiss. All cups, spoons 
and other articles used by him should be boiled or otherwise 
disinfected. Each patient should have his own set of utensils. 



340 THE COMMON AFFECTIONS 

Consumption is a disease treated less by drugs than by 
hygienic measures. A child with consumption or with a 
family tendency toward it should observe most strictly all 
the rules laid down in the first part of this book. He must 
live out of doors as much as possible and have plenty of air 
in his sleeping room. His diet should consist of an abun- 
dance of good, nourishing food, especially of milk, eggs, 
butter and oil. When exercising he must always stop short 
of fatigue. The breathing exercises described in chapter IV, 
especially those associated with arm movements, are partic- 
ularly useful. Every morning the child should take a hard- 
ening bath.* 

A child should never be allowed to have a chronic 
cough without a physician being consulted. 

THE INTESTINAL DISORDERS OF INFANCY. 

The intestinal disorders of infancy occur usually in the 
summer time, and especially among children who are fed 
upon artificial food. They are sometimes produced by chill- 
ing of the skin. As they frequently are caused by improper 
feeding, they may often be prevented by observing the direc- 
tions given in chapters XXIV and XXV. 

SYMPTOMS OF INTESTINAL DISTURBANCES. 

These symptoms are not in any way diagnostic. 

Vomiting. — Vomiting differs from the simple regurgita- 
tion that occurs when the baby has been overfed. It is ac- 
companied by coldness, pallor, and moisture. A common 
occurrence in children, it has not the same significance that it 
has in adults. Almost all the acute diseases of children are 
ushered in by vomiting. 

Diarrhea. — An infant attacked with diarrhea may have 
from four to forty passages in twenty-four hours. The 

* See chapter II. 



THE COMMON AFFECTIONS 341 

evacuations may be greenish, yellowish-green, whitish, clay- 
colored, black, brown, or even colorless. Their consistency 
may be semi-liquid or very watery. They may be extremely 
offensive or may have no odor at all. Their size varies from 
small to very large. Serum or water, mucus or slime — re- 
sembling the white of egg, and blood may be present. 

Pain. — Pain in the abdomen may occur occasionally or 
very often. It may precede each movement of the bowels 
or may be followed by the expulsion of gas from the mouth 
or from the bowels. When in pain the baby suddenly cries 
violently, alternately doubling and straightening its legs, 
arms, and trunk. This may continue until the child is bluish 
in the face and is exhausted and cold. The pain then sud- 
denly ceases. 

Fever. — In the severe affections of young children 
the fever is high. The various degrees of inflammation of 
the stomach and bowels are usually accompanied by moder- 
ate fever. 

Wasting. — The most alarming symptom that appears 
in intestinal disorders when associated with diarrhea, is the 
rapid falling away in flesh. An infant may lose a great deal 
of weight in a single day and before many hours may be- 
come shrivelled, wrinkled and cold, the fontanelles being 
depressed and sometimes the bones of the skull overlapping. 

THE CARE OF AN INFANT WITH AN INTESTINAL DISORDER. 

Owing to the marked changes that can occur in such a 
short space of time, when a baby begins to lose flesh and 
weight a physician should be consulted at once. In mild 
cases, however, and in serious cases before the physician ar- 
rives, there are many things a mother can do. 

Diet. — In the first place all nourishment must be with- 
drawn immediately. For the first six hours no food at all 
should be given. Later the baby may have small amounts 
of barley-water or albumen-water. 






842 THE COMMON AFFECTIONS 

Barley-water is prepared by putting one rounded table- 
spoonful of whole barley into an enamelled saucepan of 
water, boiling for not more than five minutes and then 
throwing the water away. To the washed barley one quart 
of water is added and allowed to simmer slowly down to one 
pint, and then strained. When, in place of whole barley, 
a barley flour is used it is prepared by rubbing up one 
rounded dessertspoonful of barley flour with a little cold 
water, stirring it into one pint of water, and allowing it to 
simmer for fifteen minutes with stirring and straining. 

To prepare albumen-water dissolve slowly the raw 
white of one or two eggs in a glass of cold water. Sweeten 
if desired and strain only if necessary to prevent clogging 
of the rubber nipple by minute shreds. It may be warmed 
slightly before being given. 

Rest. — The child should lie quietly, preferably in bed. 
It must not be raised suddenly or trotted on the knee. Dur- 
ing an attack of wind colic, however, the child's position may 
be changed; the baby may be lifted over the shoulder, and 
its abdomen may be rubbed for several minutes. This may 
aid in the expulsion of gas. 

Clothing. — The abdomen, arms and legs should be care- 
fully covered with close-fitting garments, suitable to the 
season, as described in chapter XXVII. The feet should be 
encased in thick, loose socks. An abdominal binder may be 
worn. A small hot-water bag may be applied to the stomach 
for colic if the child permits. For colic Griffith advises daily 
friction of the feet with a mixture of one part of turpentine 
and three parts of sweet oil. 

External Remedies.— For vomiting a spice or mustard 
plaster may be placed just below the ribs in the median line 
and a short distance to the left of it. A spice plaster over the 
abdomen often relieves colic. 

To prepare a spice plaster take one part each of ground 



THE COMMON AFFECTIONS 343 

ginger, cloves, cinnamon, and allspice; one-fourth part of 
cayenne pepper is added if the plaster is to be strong. Spread 
the dry and well-mixed powder evenly in a flannel bag, 
and then quilt the bag. Before applying the plaster wet it 
with hot alcohol or hot whiskey. The same spice-bag may be 
used repeatedly until it loses its strength. 

A mustard plaster or poultice is made by mixing one part 
of mustard with three, four, or five parts of flour or flaxseed 
meal. Boiling water is added and the mixture is stirred un- 
til it is of the proper softness, when it is spread on a cloth 
and applied directly to the skin or with a layer of linen or 
some other thin material intervening. It should be kept on 
until the skin is well reddened, but not long enough to 
blister. 

If the baby seems to have fever it may be bathed with 
cool water; if cold and clammy it should be given a hot bath 
or a mustard bath. 

Internal Medication. — The physician should decide 
what medicines are to be given. Under no circumstances 
should the mother give opium in any form. Nearly all the 
various soothing syrups and other infant remedies contain 
opium. All these are very dangerous when given to an 
infant and all have their share in the many deaths occurring 
every summer among infants. The soothing syrup or the 
few drops of laudanum or paregoric will no doubt cause the 
baby to sleep, but too often the little one never awakens. 
The medicine that always may be given at the beginning of 
an illness is castor oil or calomel. Colic is often relieved 
by an enema. Soda-mint may be given to relieve vomiting 
or colic. It should be mixed with an equal quantity of hot 
water and be given every half hour or hour. The dose at 
one year of age is a teaspoonful. In cases of diarrhea, until 
the doctor arrives, doses of chalk mixture may be adminis- 
tered after the oil has acted. 



PART V. 
DISEASES PECULIAR TO WOMEN. 






CHAPTER XXXIII. 

SYMPTOMS OF WOMEN'S DISEASES AND 
THEIR TREATMENT. 



Symptoms of Women's Diseases: How to observe pain; its location, character, 
degree, duration, frequency, modifications; danger-signals. Temporary 
treatment of pain: Headache, pain in the abdomen, backache. Discharges: 
White (leucorrhea), yellow, bloody; Their prevention and treatment. 
Pruritis or itching: Its cause and treatment. Constipation: Correction 
without drugs, by habit, exercise and diet. 



"A stitch in time saves nine." 

— Old Proverb. 

HE structure and functions of the female generative 
organs have been described in chapter VIII. These 
organs, like those in other parts, are liable to dis- 
eases or injury. The study of the diseases peculiar 
to women is called gynecology. Whenever any symptoms 
occur which seem to be caused by an abnormal condition of 
these organs, a physician should be consulted. 

The purpose of the present chapter is to show women 
how to observe these symptoms, that they may report them 
properly to a physician, and how to temporarily manage 
and relieve them when severe and acute, pending the physi- 
cian's arrival. 

Frequently the real condition from which a woman is 
suffering lies unrecognized because of her inaccurate ob- 
servation and description of her symptoms. 

It is not always possible, especially in the country, to 
procure a doctor at a moment's notice. In such a case a 
woman may have to suffer for hours, unless she be able to 

317 




348 SYMPTOMS OF WOMEN'S DISEASES 

obtain temporary relief. For these emergencies when no 
physician is available, it is important for the woman to know 
what is to be done. 

A woman, however, must not be continually on the 
lookout for symptoms; she should not always be examin- 
ing herself to see if she is normal. Such a practice produces 
a nervous disorder, a condition bordering close on to in- 
sanity, known as hypochondriasis or morbid introspection. 
Unfortunately any description of symptoms has a tendency 
to make hypochondriacs of its readers. 

In this book, all such description will be avoided as 
much as possible. Instead, the way to observe symptoms 
will be detailed. Only in the case of danger-signals, when 
the life of a woman depends upon her early recognition of 
the first warnings, will the symptoms themselves be fully 
described. 

HOW TO OBSERVE PAIN. 

When suffering from pain, a woman should notice 
its (i) location, (2) character, (3) degree, (4) duration, 
(5) frequency and (6) modifications. 

The location is a matter of importance. The seat of pain 
should always be pointed out to the doctor with the finger, 
rather than be described. Many women have incorrect no- 
tions as to the names of the different parts of their bodies, 
and call the abdomen or belly "the stomach," saying, they 
have a pain in "the lower part of the stomach," when they 
mean the lower part of the abdomen, a point far distant 
from the stomach. Few know the exact location of the 
various organs. Yet a woman will speak of "pain in the 
kidneys," though, as a rule, she refers to a spot below the 
position of these organs. 

It is a mistake in any case to try to designate the 
exact organ which is imagined to be the seat of pain. Pain 
in the lower portion of the back, for instance, is so often 



SYMPTOMS OF WOMEN'S DISEASES 349 

spoken of as pain in the kidneys, when it seldom comes 
from the kidneys at all. It may originate in the muscles, 
as a form of rheumatism, or in the nerves, as neuralgia or 
lumbago; or it may be due to displacements or disease of 
the generative organs, or to other conditions. If the woman 
will merely indicate with her finger the seat of pain, she 
will avoid making ridiculous and sometimes misleading 
mistakes. 

Occasionally the pain is transmitted or shoots in a cer- 
tain direction. When this occurs it should always be men- 
tioned. 

The character of the pain is often difficult to describe. 
It may be sharp, cutting, lancinating, stabbing or shooting, 
or dull, aching, gnawing, boring, throbbing, or burning. 
Sometimes it is cramp-like, coming in spasms. It may have 
a bearing-down character, or it may produce a peculiar sick- 
ening feeling. 

Much may be learned by noticing the mode of onset of 
a pain, whether it is sudden, or gradual and continuously 
increasing in intensity. 

Pains vary greatly in degree, from one very mild to 
one so severe as to cause fainting. A woman should always 
avoid exaggerating her sufferings, as she thereby may pre- 
vent her physician from making a correct diagnosis. On the 
other hand, she must not minimize the pain in an effort to 
appear brave or stoical. This is even worse than exag- 
geration. 

A pain may be of long or short duration. It may be 
present all the time, as in many chronic conditions, or it 
may last a whole clay or a few hours or only a minute or 
a few seconds. 

The frequency of pain should be noticed. Some pains 
recur at regular intervals, separated by periods of freedom 
from pain. These are called intermittent or remittent pains. 






850 SYMPTOMS OF WOMEN'S DISEASES 

When occurring at definite intervals, they are called periodic. 
When pains attack the patient in "spells/' being extremely 
severe for a limited time, they are called paroxysmal. 

The time of occurrence is important. Some pains occur 
only during the day and are said to be diurnal; others only 
during the night and are called nocturnal. Many occur 
just before meals, or shortly after, or several hours after. 
Pain may be modified in many ways. It is usually increased 
by pressure, but it may be relieved by it. As a rule, it is 
made worse by movement, but benefited by rest. Some- 
times amelioration is produced by heat, at other times by 
cold. The climate, weather or season may also have an 
influence. 

Symptoms that are Danger-Signals. — A woman should 
regard as a danger-signal of sufficient importance to warrant 
the immediate summoning of a physician, the occurrence 
of pain in the abdomen when severe and localized to one 
spot, or when associated with prostration, marked pallor, 
great abdominal tenderness, or chills and fever.. 

TEMPORARY TREATMENT OF PAIN. 

Pain is Nature's notification or warning that an ab- 
normal condition is present. The cause of a pain should be 
investigated and removed by treatment, for "which the ser- 
vices of a physician are required. The pain itself is seldom 
treated, yet there are times when the pain is so severe that 
something must be done to relieve it. Inasmuch as on such 
occasions a physician is not always within reach, it is impor- 
tant for a woman to be familiar with various expedients 
which may be tried before the doctor arrives. The proced- 
ures given in this chapter are of a temporary nature and only 
relieve the pain; they do not cure it. The measures adopted 
for the relief of pain depend upon the location of the trouble. 



SYMPTOMS OF WOMEN'S DISEASES 351 

How to Relieve a Headache. — Headache is frequently 
benefited by a cooling compress. This consists of a hand- 
kerchief or cloth tied across the forehead and kept cold by 
being repeatedly wrung out of cold or ice water. The com- 
press must never be allowed to become warm, but must be 
dipped in the cold water at frequent intervals. 

In cases where this fails to relieve the headache, or 
even tends to increase it, the stimulating cold compress may 
be tried. Several folds of muslin or linen — a handkerchief 
will answer — are wrung out of cold water and applied to 
the forehead. Over this a band of flannel is placed, extend- 
ing for an inch above and below the other and reaching 
around the head, being tied or fastened with pins. The inside 
linen bandage will soon become warm, but it must not be 
disturbed for at least an hour. It may then be again dipped 
in cold water and the bandages applied as before. 

Where both the cooling and the stimulating cold com- 
press fail to give relief, a hot compress or towel wrung out 
of hot water may be tied around the head, or a menthol 
pencil may be rubbed over the temples and brows. A hot 
foot-bath, with or without mustard, or a hot or cold hip-bath 
or sitz-bath, will often draw the blood from the head and 
thus relieve the headache. In every case a cathartic is in- 
dicated; often it alone will work a cure. 

When the headaches always come while the eyes are 
being used for near work, such as reading, writing or sew- 
ing, the eyes should be examined by a competent oculist 
(not optician). 

Attention to the hygienic rules, especially those in re- 
gard to work, rest, recreation and exercise, will aid largely 
in banishing headaches, which often are due to impover- 
ished blood, overwork and lack of proper exercise, fresh air 
and sunlight. A general tired, languid, sleepy feeling, or 
a dull ache in the head, will frequently disappear after a 



352 



SYMPTOMS OF WOMEN'S DISEASES 



brisk walk or a game of tennis or tether ball. A woman 
subject to headaches should always consult a physician. 

Abdominal Pains. — Pain in the abdomen may be ben- 
efited by local heat. This may be applied by means of a hot- 
water bag or of cloths wrung out of hot water, to which 
sometimes a teaspoonful of turpentine is added. A hot poul- 
tice of flaxseed or other material often soothes the pain. 





Hip-bath or Sitz-bath. 




Hot- water Bag. 



Ice Bag. 



In cases where heat only increases the suffering, cold 
may be applied, usually in the form of an ice bag. 

When the abdomen is pendulous and lacks support, the 
pain may be due to a dropping of one or more of the or- 
gans. In such cases with the wearing of an abdominal elastic 
bandage the pain often disappears. 

When attacked with severe abdominal pain the woman 
should at once go to bed and send for the doctor. 

If the pain seems to be in the lower portion of the 



SYMPTOMS OF WOMEN'S DISEASES 



353 



abdomen, or in the pelvis, it may be relieved by heat ap- 
plied to the parts internally by means of a vaginal douche, 
also known as an injection. The bag of a fountain syringe 
should be filled with water as hot as can be borne, to which 
ordinary table salt has been added in the proportion of a 
teaspoonful to a pint. The bag should be hung low, so as 





Forms of the Douche. 

to let the water run out slowly; as it is the heat of the water 
that does the good, the injection should consequently last 
as long as possible. A douche-pan or other receptacle is re- 
quired to receive the water as it leaves the parts. 

PAINS IN THE BACK, OR BACKACHE. 

Pain in the back may be treated temporarily in a sim- 
ilar fashion by heat or cold. The various plasters can do no 
harm in these conditions, and may do some good. Pain in 
the back is not normal, although it is experienced by so 
many women. It may be due to displacement of the womb, 
to a tear, to a movable kidney, to rheumatism or to other 
conditions. In every case an examination by a physician 
is advisable. 

Backache is frequently caused by an improper mode oi 
standing. Instead of the spine being hold erect, the shoul- 

23 



354 SYMPTOMS OF WOMEN'S DISEASES 

ders are pulled back and the abdomen thrown forward, 
which position imposes a strain on the muscles of the back. 

DISCHARGES FROM THE VAGINA. 

Discharges from the vagina (described in chapter VIII) 
may be of three kinds, white, yellow, or bloody. They may 
be of little or of grave significance. A physician should 
always be consulted to find out the cause and to prescribe 
the treatment. 

A WHITE DISCHARGE, OR LEUCORRHEA. 

Cause. — Leucorrhea may be due to a catarrh, or an acute 
or chronic inflammation of the neck of the womb, the glands 
being congested and secreting a large amount of mucus, 
which finds its way externally. This condition is known 
as ''leucorrhea" (from two Greek words, meaning "white 
flowing'') or "the whites." It may be compared to "catarrh 
of the head," in which there is an increase in the mucous 
secretion of the nose, producing the excessive discharge. 

Leucorrhea, as a rule, is caused by some local or gen- 
eral condition. Its most common cause is a tear of the neck 
of the womb, which sets up an inflammation. It occurs 
also when the uterus is displaced or bent into an abnormal 
position and also when after labor, miscarriage, or even 
menstruation, it fails to contract down to its normal size. 
The use of frequent douches of cold water to prevent con- 
ception is said to produce it. An obstinate form is some- 
times due to gonorrhea. In women with a tendency to con- 
sumption a white discharge is common, its severity depend- 
ing entirely upon the general health. Leucorrhea may also 
be due to seat-worms. The same occurs in syphilis. 

The condition in many cases, especially where it occurs 
in young girls, is caused by a general state of ill health; in 
every instance the severity depends upon the general health. 



SYMPTOMS OF WOMEN'S DISEASES 355 

The leucorrhea may occur only at those times when the gen- 
eral health is impaired by overwork, anxiety or by any other 
cause, and even when apparently cured, it is apt to reappear 
whenever the woman is subjected to such depressing in- 
fluences. 

Recognition. — Leucorrhea is recognized by the exist- 
ence of a discharge composed of thick, opaque, tenacious 
mucus. With it may be present a slight backache and a 
feeling of vague discomfort or pain in the pelvis. An or- 
dinary leucorrhea is not contagious in any way. 

Treatments — A physician must determine the cause. 
If the discharge be due to a displacement of the uterus or 
to a tear in the neck of that organ, it will not be cured 
until the tear is repaired or the womb put back in position. 
In many cases local treatment by the physician will be re- 
quired. Hot douches, as described on page 353, will usually 
aid in hastening the cure and, in the absence of a local cause, 
will be the only local treatment required. In most cases the 
physician will prescribe a tonic. The bowels must always 
be kept regular. When seat-worms are the cause their re- 
moval effects a cure. 

In every case, whether the discharge is due to a gen- 
eral state of poor health or to a definite local cause, general 
hygienic measures are always necessary. The only pre- 
vention is a strict adherence to the rules of correct living. 
The directions in the chapters on eating, bathing, clothing, 
exercise, rest, recreation and work, should be faithfully fol- 
lowed. Only by these means can leucorrhea be made to 
disappear as a common condition in women. 

A YELLOW DISCHARGE. 

The occurrence of a yellow discharge should receive 
immediate medical attention. It usually signifies gonorrhea, 






356 SYMPTOMS OP WOMEN'S DISEASES 

which in women is a very serious affection, being responsible 
for a large percentage of her pelvic troubles. 

A BLOODY DISCHARGE. 

At any other time than the menstrual period, a bloody 
flow should be viewed with concern. A physician should 
always be consulted without delay. 

Increase in the amount of blood lost at the menstrual 
period and slight bleeding* in the interval, occurring in 
women over thirty years of age, demand immediate and 
careful examination. It may indicate something very 
serious. 

Any bleeding from the vagina in a woman who has 
passed the menopause, or change of life, should arouse the 
gravest suspicion and be reported at once to the physician. 
Many dangerous and often fatal maladies begin in this way. 

PRURITIS, OR ITCHING. 

Pruritis vulvae, or itching of the vulva or external parts, 
is an extremely annoying affection. It is sometimes so 
severe that it debars a woman from the society of her 
friends. Extension may occur to adjacent parts. 

Causes. — Itching may be due to a great variety of 
causes. It may be produced by an eruption on the vulva, 
such as eczema, or by the irritating discharge of an inflamma- 
tory or cancerous condition of the womb. In children the 
presence of seat-worms or thread-worms often accounts for 
it. Itching frequently occurs in diabetes. 

The treatment depends largely on the cause, usually 
consisting in its removal. The services of a physician are 
often required to determine the cause and to prescribe treat- 
ment. In a severe and intractable case a physician should 
always be consulted. 



SYMPTOMS OF WOMEN'S DISEASES 357 

In mild cases, and on the first occurrence of itching, 
there are many things a woman can do. If an irritating 
discharge be present, it should be treated as just detailed. 
The parts should be kept clean by frequent douches. A 
>pledget of cotton should be inserted to absorb the discharge 
and should be renewed as required. The stools of children 
should always be examined for the thread-worm. Various 
dusting powders may be used. An excellent one consists 
of equal parts of bismuth subnitrate and prepared chalk. 
Ordinary talcum powder is very serviceable. 

CONSTIPATION. 

The great majority of women are constipated. Many 
will go a week without having a passage; some go even 
longer. The regulation of the bowels is largely a matter 
of habit. Medicines are of little use as a cure, although 
they may act for a short time. Such drugs as castor oil, 
salts, licorice powder, magnesia, A. S. & B. pills, and so 
forth, should never be taken regularly, as they lose their 
effectiveness with continued use. A woman should ac- 
custom herself to habits of regularity. A sedentary life 
without exercise is the commonest cause of constipation. 

Treatment. — This condition may be corrected by exer- 
cise, especially by those described in chapter IV. Massage of 
the abdomen may be employed as a substitute for active 
exercise. Plenty of water, hot or cold, should be taken. A 
glassful on getting up in the morning and another at bed- 
time are useful. 

Attention to diet may itself cure constipation. Vege- 
tables, fruits and coarse breads should be taken freely. The 
vegetables that are most laxative are tomatoes, spinach, 
lettuce, asparagus, Spanish onions, salsify, cabbage and 
celery, especially spinach and tomatoes. The coarse cereals, 



368 SYMPTOMS OF WOMEN'S DISEASES 

such as oatmeal, cornmeal and wheaten grits, and bread 
made of coarse flour, such as Graham, rye, corn, oats and 
whole wheat meal, also help to relieve constipation, as well 
as to prevent it. The addition of bran to ordinary flour 
makes an especially efficacious bread. Nearly all fruits 
have a laxative influence, which is most marked when they 
are taken alone. Honey and molasses are better than any 
medicine. It is well to take fruit, honey or preserves with 
each meal, or at least with breakfast. 



DANGER IN PATENT MEDICINES. 

Thousands of women to-day are ruining their health 
by taking patent medicines. These seemingly innocent rem- 
edies, often labelled "harmless, " frequently contain the most 
dangerous drugs. Few of the States have laws preventing 
the sale of such poisons, despite the fact that in many in- 
stances the Coroners' verdicts have ascribed the cause of 
death to their use. The makers of the patent medicines ad- 
vertise in the daily newspapers, guaranteeing to cure every 
disease known to mankind. These advertisements are so 
cunningly and so attractively worded that a woman is de- 
ceived by their falsehoods and wastes her money on these 
harmful potions. After taking a bottle and finding her pain 
relieved by the opium it contains, and her strength seeming- 
ly restored by the alcohol which forms its chief ingredient, 
she imagines that she is on the road to recovery. Then 
bottle after bottle is consumed, while the disease grows pro- 
gressively worse without attracting the woman's notice, 
so well are its symptoms masked by the patent medicines. 
When at last the victim discovers her mistake, she too often 
is past all cure. 

The advertisements usually describe little aches and 
pains that are of no consequence, and state that they are 



SYMPTOMS OF WOMEN'S DISEASES 359 

symptoms of a serious disease which can best be cured by 
the use of the patent medicine recommended. Women in 
perfect health are thereby led to imagine that their organs 
are diseased, and thus acquire the drug-taking habit. There 
are hundreds of "sure cures for consumption'' on the market, 
although the makers of these so-called "cures" well know 
that fresh air, good food, and proper hygienic living alone 
will cure this disease. Most of these "consumption cures" 
contain chloroform and opium which may check or ease the 
cough, but which hasten the progress of the disease and 
shorten the life of the sufferer. 

Alcohol is the drug most commonly used in patent med- 
icines- Most of the whisky-cures contain it in very large 
quantities. The various "tonics," "sarsaparillas," "vegeta- 
ble compounds," "celery compounds," "bitters," etc., con- 
tain as a rule more alcohol than is found in many intoxica- 
ting beverages. Beer, ale, stout and porter, for instance, 
average from three to eight per cent, of alcohol; a well- 
known patent medicine contains twenty-eight per cent. 
The alcohol in claret is nine per cent. ; in a much-advertised 
sarsaparilla it is twenty-six per cent. How can a woman 
object to her husband wasting his wages on drink when she 
herself spends them for a vegetable compound containing 
five times as much alcohol as is in his glass of beer? A 
mother often wonders where her son developed his taste 
for liquor, forgetting that throughout all her life, and espe- 
cially when pregnant, she had been dosing herself with one 
of the popular stomach bitters containing three or four 
times the amount of alcohol that is in champagne. 

The most dangerous of all the patent medicines, how- 
ever, are the headache powders. The majority of these con- 
tain a poison known as acetanilid, which has an injurious 
effect on the heart. Frequently after taking one of the pow- 
ders a woman becomes faint and weak, her lips turn blue, 



360 SYMPTOMS OF WOMEN'S DISEASES 

her hands feel cold. In several instances death has shortly 
followed. In one case, an eighteen-year-old girl went to a 
drug store for something to relieve her headache and was 
given a box of headache powders which are extensively ad- 
vertised on sign boards and in street cars. As is usual with 
such patent medicines, there was nothing on the label to 
warn her of the dangerous drugs they contained. On the 
contrary the claim was made that the medicine not only was 
harmless but strengthened the heart and produced better 
blood. The girl followed the printed directions and took 
two powders. In three hours she was dead- The coroner 
in his verdict attributed the death to the headache powder, 
mentioning it by name. 

Often the heart of one who makes a practice of taking 
headache powders does not give way at once, but becomes 
weaker very gradually without causing noticeable symp- 
toms, until during an attack of the grip or some other disease 
it is unable to stand the extra strain and then suddenly gives 
out. 

Cocaine is a drug which cannot be purchased from the 
apothecary under its own name, but which may easily be 
procured in a patent medicine. Most all the "catarrh pow- 
ders" and "catarrh cures" contain cocaine and consequently 
are harmful. The cocaine habit has often been formed from 
taking catarrh cures. 

In any illness the important fact for every woman 
to remember is that patent medicines as a rule are all dan- 
gerous. They may ease the pain, check the cough, or pro- 
duce a temporary stimulation which gives a false impression 
of increased strength, but they never cure the disease. They 
merely mask or hide the symptoms for the time being. On 
the other hand they frequently do harm, causing the forma- 
tion of drug habits, injuring the heart and sometimes even 
producing death. 







MOTHER'S OWN DARLING SLEEPS 



This beautiful piece o( domestic love showing the mother pausing to hush the baby and s 
its crying troubles, is a touching scene easily represented and always pleasing. 



CHAPTER XXXIV. 

THE DISORDERS OF MENSTRUATION. 



Absence of menstruation: Causes; Symptoms; Treatment. Sudden checking 
of the monthly bleeding. Scanty menstrual flow. Vicarious menstruation. 
Profuse menstrual discharge or flooding. Painful menstruation. 



'They talk of short-lived pleasures — be it so — 
Pain dies as quickly ; stern, hard-featured pain 

Expires, and lets her weary prisoner go ; 
The fiercest agonies have shortest reign." 

— Bryant. 



U 



NDER normal conditions a woman should menstruate 
regularly every twenty-eight days without experi- 
encing pain or any other disturbance. Yet, under 
the impression that suffering is the natural lot of 
her sex, a woman often will every month undergo the 
most excruciating agony without making the slightest effort 
to obtain relief. On the other hand, this same person is 
apt to become greatly exercised if the flow should be de- 
layed or missed, although such an occurrence may be the 
result of merely a change in her surroundings. 

ABSENCE OF MENSTRUATION. 

Menstruation may be absent in the sense that it has 
never appeared and it may be suppressed. 

Causes. — The absence or the suppression of menstrua- 
tion may be due to a number of conditions in the woman 

861 



362 THE DISORDERS OF MENSTRUATION 

herself and in her environment. Most all the cases in which 
the monthly sickness has been absent for a longer or shorter 
period are caused by physical or mental overwork and in- 
sufficiency of food. Absent or suppressed menstruation is 
quite commonly seen in studious school-girls who devote 
too much time to their books and not enough to exercise in 
the open air; it is not rare in shop girls who starve them- 
selves, that they may be able to appear in better clothes 
than their small salaries would ordinarily allow. 

When a defect of development exists in the organs of 
generation, menstruation may never occur. This, however, 
is an exceedingly rare condition. When after labor, as 
sometimes though rarely occurs, the womb contracts to a 
size much below the normal, the menstrual flow may fail 
to reappear. 

The monthly sickness may be suppressed should dis- 
ease or injury be present in any of the female organs. 

In the acute general diseases, such as typhoid fever, 
menstruation is often absent and may return only with the 
full restoration of the general health after convalescence. 
The menses are also frequently suppressed in chronic gen- 
eral diseases, especially those associated with debility, such 
as chlorosis, anemia, malaria and consumption. An exces- 
sive development of fat may prevent the flow appearing even 
in persons whose general health appears to be excellent. 
Absence of the menstrual function is a frequent accompani- 
ment of mental disturbance, occurring quite commonly in 
insanity and being often produced by fright, grief or anx- 
iety. The same condition results from changes of climate 
and is experienced by immigrants for some time after their 
arrival. It may also be brought about by change of sur- 
roundings, as when a woman moves from the country to a 
large city, and it may continue until she has become accus- 
tomed to her new environment. 



THE DISORDERS OF MENSTRUATION 363 

Rare cases have been known of women who were ap- 
parently in perfect general health and whose sexual organs 
seemed to be well developed but who never had menstruated. 



SYMPTOMS EXPERIENCED WHEN MENSTRUATION IS ABSENT. 

Menstruation may be absent without causing the slight- 
est inconvenience. On the other hand, there may be present 
at the menstrual period a feeling of general disturbance with 
headache, flashes of heat, nervousness, nausea and vomit- 
ing, and fullness and pain in the pelvis. In some cases 
various eruptions on the skin have been noticed. 

The most common symptom associated with this con- 
dition is poor health, both mental and physical. This, as 
has been shown, although frequently regarded as the result 
of the suppression, is usually really the cause of it. 

Treatment. — Almost every case will require treatment 
directed to the improvement of the general bodily health. 
The girl or woman must live in strict accordance with the 
hygienic rules laid down in this book. She should exercise 
in the open air as directed in chapter VII; in fact, as much 
of her time as possible should be spent in the fresh air and 
in the sunshine. This is especially necessary in the case of 
overworked school-girls, who must be made to apply them- 
selves less closely to their studies. Every morning the cold 
hygienic bath described in chapter II should be taken. Sea- 
bathing and a change of climate and surroundings are also 
beneficial. There are a number of medicinal remedies which 
the physician may prescribe. 

SUDDEN CHECKING OF THE MENSTRUAL FLOW. 

During the menstrual flow the bleeding may be sud- 
denly suppressed. Such an occurrence may follow an ex- 
posure to cold or an unexpected emotional disturbance. It 



364 THE DISORDERS OF MENSTRUATION 

may or may not be associated with pain, but is liable to cause 
the patient trouble. 

When the menses are suddenly checked the girl should 
be given a hot foot bath and be put to bed, with moist heat 
applied to the lower abdomen. At the following menstrual 
period the strictest hygienic precautions should be observed 
as detailed in chapter X. 

The special treatment in each case will depend alto- 
gether upon the cause. Whenever the menses are absent 
or suppressed it is always advisable to consult the family 
physician, who may recommend that an examination be 
made by a gynecologist. 

SCANTY MENSTRUAL FLOW. 

When the menstrual flow is much less than normal, 
one of the conditions may be present which have been men- 
tioned as giving rise to absent or suppressed menstruation. 
When this is the case the treatment is the same as that 
described on the preceding pages. 

It must be borne in mind, however, that certain women 
may have individual peculiarities in this respect without de- 
parting from the limits of health. 

PROFUSE MENSTRUAL DISCHARGE OR FLOODING. 

The presence of flooding or of excessive menstrual 
bleeding is a much more significant condition than absence 
or suppression of menstruation, and it usually indicates a 
more serious state of affairs. Many diseases of the female 
generative organs have as a prominent symptom an increase 
in the duration and amount of the menstrual flow. An 
enumeration of these many and varied diseases would serve 
no useful purpose. Moreover, it might tend to alarm un- 
necessarily any woman who imagined that her periods were 
unduly prolonged. 



THE DISORDERS OP MENSTRUATION 365 

If the bleeding is really excessive, there are two things 
a woman can do — one dangerous, the other safe. If a 
woman wants to tinker with her life and her health she 
can take any one of the many worthless patent medicines 
that the misleading advertisements guarantee to cure con- 
ditions which she imagines are exactly like hers. If she 
takes these alcoholic beverages* long enough she may de- 
lay applying for proper relief until the condition is past all 
cure. 

The only safe thing for a woman to do when she notices 
excessive bleeding is to immediately consult a reliable phy- 
sician. Doctors who advertise — the so-called quacks — are 
almost as dangerous as the advertised medicines. 

VICARIOUS MENSTRUATION. 

The condition in which the discharge of blood at the 
time of the menstrual period occurs from some part of the 
body other than the uterus has already been discussed in 
chapter X. 

The treatment of vicarious menstruation should be en- 
tirely hygienic, directed to the improvement of the general 
health. A physician should be consulted to find out if any 
physical defect or local disease is present. 

A woman must never take it upon herself to decide that 
a hemorrhage or bleeding is due to vicarious menstruation. 

PAINFUL MENSTRUATION. 

Menstruation normally is not accompanied by pain. 
When pain is present it is usually due to a condition which 
can be removed. Consequently it is seldom necessary for 
a woman to suffer at the time of her periods. 

Pain occurs at the time of the menstrual period in the 
conditions called anemia and chlorosis, which arc associated 

*See chapter XXXIII. 



366 THE DISORDERS OF MENSTRUATION 

with impoverished blood. It is often due to an obstruction 
to the flow of blood produced by a bending forward of the 
uterus or of its neck. The pains then are characteristic; 
they begin in the center of the lower abdomen and are of a 
violent character, extending down the thighs and in later 
years to the whole of the pelvis and the back. They occur 
for several hours before the flow begins, being probably 
caused by strong contractions of the uterus in an endeavor 
to drive the accumulated blood past the bend that prevents 
its escape. As soon as the blood begins to flow freely the 
pain is relieved and may not reoccur until the next period. 
While the pain is at its height the woman may experience 
nausea and vomiting. 

When painful menstruation is due to a bend in the 
womb it is seldom outgrown. On the contrary, if not re- 
lieved, the suffering tends rather to increase. The proper 
methods of treatment in this condition will be prescribed in 
each case by the attending physician. 

When the pain experienced at the monthly period is 
due to an impoverished condition of the blood or to a lower- 
ing of the general health, the hygienic treatment already 
described is indicated. 



CHAPTER XXXV. 



MISCARRIAGE AND ITS PREVENTION 



The Course of a Miscarriage. The Causes of a Miscarriage. The Signs of a 
Miscarriage: Pain, hemorrhage, the expulsion of the ovum. The Danger 
of an Abortion or Miscarriage. The Prevention of a Miscarriage; How 
to avert it when threatened. Treatment of an Inevitable Miscarriage; Its 
after treatment. 

"Who would not give a trifle to prevent 
What he would give a thousand worlds to cure ?" 

— Young. 



HE fetus is sometimes expelled before it has reached 
its full development. Such an accident may occur at 
any time during the course of pregnancy. 



THE COURSE OF A MISCARRIAGE. 

The course of an abortion or miscarriage is much the 
same as that of a labor at term. The contraction of the uterus 
in its efforts to expel its contents causes a gradual dilatation 
of the os or mouth of the cervix, which is followed by the expul- 
sion of the embryo and its membranes, together with the pla- 
centa or afterbirth. After this, the womb contracts still fur- 
ther until it has again reached its normal size. 

THE CAUSES OF A MISCARRIAGE. 

There are many conditions which may produce a miscar- 
riage. When the fetus is diseased it may be expelled prema- 
turely. The presence of syphilis in either of the parents may 
lead to a similar termination of pregnancy. The woman is, 

367 



368 MISCARRIAGE AND ITS PREVENTION 

moreover, susceptible to a number of influences which may 
cause a miscarriage; a blow or a fall may produce it. Some- 
times the uterus is extremely irritable, so much so that it is 
excited to contraction by the most trivial occurrence, such as 
washing at the tub, sweeping, dancing, taking a long walk, 
a horseback ride or a surf bath, making a misstep, being jolted 
by a carriage, being subjected to a fright or shock, and so 
forth. Anything that shakes or agitates the womb may have 
a similar effect. Consequently when the woman suffers from 
St. Vitus' dance, uncontrollable vomiting or coughing, or from 
convulsions due to kidney trouble or epilepsy, hysteria or other 
nervous affections, her pregnancy is liable to be interrupted. 
She may also lose the child when she is attacked with severe 
general disease such as pneumonia. Inability of the uterus to 
expand on account of a backward displacement, or an over- 
distention with twins, or with an excess of the waters or liquor 
amnii usually produces a miscarriage. 

THE SIGNS OF A MISCARRIAGE. 

A condition that is always present when a miscarriage 
is threatened or has actually occurred is hemorrhage. The 
bleeding may be slight or excessive. The blood usually does 
not flow in a steady stream, but is expelled from time to time 
in the form of clots. Yet, as there are other conditions which 
might cause a hemorrhage, this symptom alone cannot be 
regarded as diagnostic. 

Pain is an almost constant symptom, its intensity being- 
greater the further the pregnancy is advanced. It may, how- 
ever, be absent, especially in early miscarriages. 

The one sign by which the occurrence of a miscarriage 
can be verified or, to use a medical term, diagnosed is the 
expulsion of all or part of the ovum. The appearance of the 
substance expelled varies, depending upon whether or not the 



MISCARRIAGE AND ITS PREVENTION 369 

embryo is surrounded by its various coverings. When envel- 
oped in the membranes it may appear as a ball of flesh, which, 
on being opened, is found to contain the embryo. On the other 
hand, it may be cast off as a sack with thin transparent walls, 
through which the embryo may be seen lying in the waters. 
Sometimes the whole ovum is so minute that it escapes among 
the clots of blood without being noticed. When the portions 
of membranes, which resemble pieces of flesh, are floated in 
water they are seen to be studded over with little projections 
which give to them somewhat the appearance of a chestnut 
burr. 

When the whole embryo is expelled with all its membranes 
the miscarriage is said to be complete. An incomplete abor- 
tion or miscarriage, on the other hand, occurs when a portion 
of the embryo or its membranes remains behind within the 
uterus. 

THE DANGER OF AN ABORTION OR MISCARRIAGE. 

Every abortion or miscarriage is attended with a certain 
amount of danger. When the ovum is not expelled in its en- 
tirety, parts of the membranes remaining behind in the womb 
may putrefy, thus poisoning the whole system, or else by their 
presence prevent firm contraction of the womb, thus causing a 
persistent hemorrhage. The mortality of miscarriage is almost 
as high as that of child-birth. Most fatal of all are the criminal 
and self-adduced abortions. In these cases there is also the 
danger of blood poisoning or infection from the use of hands 
or instruments which are not surgically clean. The added risk 
of injury from the unskillful use of instruments is also very 
great. 

THE PREVENTION OF A MISCARRIAGE. 

When it is known that, owing to an irritable uterus, a 
woman has a tendency to abort, every precaution should be 
24 



370 MISCARRIAGE AND ITS PREVENTION 

taken to guard her from any influence that might stimulate 
the contraction of the uterus. At the times corresponding to 
her menstrual periods all efforts in this direction must be re- 
doubled. The woman should be protected from nervous shocks, 
undue physical exertion, errors in diet and marital intercourse. 
In the most severe cases rest in bed may be necessary, some- 
times for the whole or greater part of pregnancy, certainly 
during those days upon which the menstrual period usually 
falls. 

When the cause of the habitual miscarriage is known, 
treatment should be directed to its removal. A displaced 
uterus must be restored to its proper position and kept there. 
A general disease such as syphilis always requires treatment. 
Coughing, vomiting and convulsions should receive appropriate 
management. In each case the physician in charge will decide 
what is to be done. 

To Avert a Threatened Miscarriage. — When, during the 
course of a normal pregnancy, bleeding from the vagina is ob- 
served, a miscarriage is threatened. The woman in whom this 
occurs may be perfectly healthy and of sound constitution ; her 
generative organs may be normal; and she may never previ- 
ously have aborted. Some extra exertion or some slight vio- 
lence, however, may have partially separated the developing 
fetus from the wall of the womb. If no suspicious fleshlike 
pieces have been passed there is often a chance of averting this 
accident. 

The woman must at once be put to bed on her back in a 
darkened room where everything is kept quiet. The external 
genital region musi be cleansed thoroughly with soap and 
water and then bathed with a i to iooo bichlorid of mercury 
solution. A sterile gauze dressing should next be applied and 
held in place by a T-bandage, which consists of two strips of 
muslin about four to six inches wide, fastened together to form 



MISCAEEIAGE AND ITS PREVENTION 371 

a T. The top or bar of the T is tied about the waist and the 
stem or tail of the T is brought down in the back and carried 
over the gauze dressing to the front, whence it is brought 
up again, the end being fastened to the part that goes 
around the waist. The physician, who should be immediately 
summoned, will probably give medicines that will diminish the 
nervous sensibility and render the uterine muscles less irri- 
table. 

It cannot be emphasized too strongly that in every case 
v/here bleeding from the womb occurs during pregnancy the 
physician must be sent for at once and that everything passed 
must be saved for his inspection. 

TREATMENT OF AN INEVITABLE MISCARRIAGE. 

When a miscarriage cannot be prevented, it is treated in 
much the same manner as a labor at term. A physician should 
always be called in. Strict asepsis must be observed as de- 
scribed in Chapter XXI. Everything that comes in contact 
with the woman — -hands, instruments and dressings — must be 
surgically clean. All clots and all dressings must be saved for 
examination by the physician ; in this way he will be able to tell 
whether or not the whole embryo with all its coverings has 
been passed — a most important point. The precise line of treat- 
ment to be followed in each case will always be directed by the 
physician in charge. 

The After Treatment of a Miscarriage. — A great deal 
of unnecessary sickness and chronic invalidism is due to the 
fact that women do not thoroughly appreciate the necessity oi 
recovering completely from a miscarriage before taking up 
their daily work. Too often do they regard a miscarriage as 
a matter of little moment and insist on being up and about in 
a few days after this accident. It is often with the greatest 
difficulty that a physician can persuade his patient to remain 
in bed for even ten days or two weeks. 



372 MISCARRIAGE AND ITS PREVENTION 

The after treatment of a miscarriage is as important as 
that of a delivery at full term. The author does not wish to 
unnecessarily alarm a woman who may have met with a mis- 
carriage by enumerating the many sources of danger connected 
with neglect of this condition. He therefore will merely state 
that if a woman desires to undergo a complete recovery after 
having a miscarriage, she must obey implicitly all the instruc- 
tions of her physician. If she follows his advice faithfully she 
will probably never in the future experience any ill effects of 
her mishap. 




Copyright, 1904, by Burr Mel- 

YOUNG WOMANHOOD'S CHARMS. 

Regularity of feature, sweetness of exp\ shapely arms 

and hands, symmetry of form with a wealth of hah 
sameness to womanhood which should be cultivai 



CHAPTER XXXVI. 

STERILITY: ITS CAUSES, PREVENTION 
AND CURE. 



The woman not always to blame. Causes of Sterility in Women: Abnormali- 
ties, displacements, lacerations, inflammation; General conditions, such as 
obesity, anemia, etc.; Alcoholism; Absence of affinity; Lack of modera- 
tion. Prevention of Sterility. The Cure of Sterility. 

"Call not that man wretched who, whatever ills he suffers, has a child 
to love." — Southey. 



Y sterility is meant the inability to produce offspring. 
It is believed that about one out of every eight or ten 
marriages is barren. The fault, however, does not 
always lie with the woman ; in every six childless mar- 
riages about one is due to sterility in the husband. Conse- 
quently in every case of barrenness, before the wife is sub- 
jected to examination or treatment, the husband should first 
consult a physician. 

CAUSES OF STERILITY IN WOMEN. 

Sterility in the female may be due to one of many causes. 
It may result from some abnormality or malformation of the 
internal or external generative organs, a condition that may 
have existed since birth. The presence of a tumor may pre- 
vent conception. A displacement or bending of the womb may 
have a similar effect. Lacerations or tears that have occurred 
during labor and have not been repaired likewise may inter- 

873 



374 STERILITY: ITS CAUSES, PREVENTION, CURE 

fere with the child-bearing function. One of the commonest 
causes of sterility is inflammation of the womb, especially when 
this has become chronic. Disease of the ovaries also frequently 
produces such a condition. Disease of the Fallopian tubes, 
however, is the most common cause. As the ovum must pass 
through the tube in order to reach the womb, anything that 
tends to prevent its passage by blocking or constricting the 
tube will prevent its fertilization. The tubes become blocked 
and constricted as the result of inflammatory processes, both 
acute and chronic. Acute inflammation of the Fallopian tubes 
is usually due to septic infection, occurring at childbirth or 
during a miscarriage. Chronic inflammation, a much more 
common condition, has its origin usually in gonorrhea, and 
occurs not rarely in young married women who have been 
infected by their husbands. Sterility also sometimes results 
when the vaginal discharge or leucorrhea that accompanies 
inflammation of the uterus or of the vagina is of such a char- 
acter as to destroy the spermatozoa or male cells. 

There are several general conditions that may be respon- 
sible for sterility. The one of these of most frequent occur- 
rence is great obesity. Very fat women are usually barren. 
Some authors seem to think that the body cannot both produce 
fat and produce offspring. It is well known that at the age 
when child-bearing ceases women often become stout, and that 
women who soon after marriage rapidly accumulate fat rarely 
have more than one or two children. A woman who suffers 
from anemia may be sterile in consequence. Diseases such as 
diabetes, cancer, consumption and Bright's disease may also 
be associated with barrenness. 

The habitual use of alcohol is apt to prevent the occur- 
rence of conception. Women addicted to self-abuse also seldom 
bear children. Authorities have come to the conclusion that 
in some cases sterility is due to a lack of affinity, so to speak, 
between husband and wife. Lack of moderation in the marital 
relations is also a well-recognized cause of sterility. 



STERIXiITY: ITS CAUSES, PREVENTION, CURE 370 

In each case the physician in charge must decide what is 
the cause of the sterility. 

PREVENTION OF STERILITY. 

Knowing the causes that produce sterility, one can often 
prevent such an occurrence by avoiding them. Any diseased 
condition should be attended to at once. Lacerations should 
be repaired as soon as possible after they occur. A displaced 
organ should be put back in position. Proper care during and 
after a labor or miscarriage will do much toward preventing 
barrenness. In addition to the moral aspect, the fact that a 
woman who has a£ abortion performed on her usually becomes 
sterile should act as a deterring factor to those who regard 
with complacency this destruction of a human life. If women 
would insist on marrying only those men whose lives have been 
pure, many more marriages would be fertile than are so at the 
present day. 

THE CURE OF STERILITY. 

Before the proper remedy can be applied, the cause of the 
unproductiveness in the individual case must be recognized. 
In every instance the investigation should include both the 
husband and the wife. Consequently,- before a woman is sub- 
jected to an examination, the husband should consult a reliable 
physician, who will determine whether or not the fault lies with 
him. If this investigation should prove negative, the wife must 
put herself in the hands of a competent physician. Neither 
man nor woman should ever have anything to do with physi- 
cians who advertise — the so-called "quacks." 

Some cases of barrenness can be cured, others cannot. 
Those due to errors in development and to malformations are 
rarely, if ever, amenable to treatment. When sterility is 
caused by abnormal conditions resulting from chronic inflam- 
mation of one or more of the organs of generation, or to a 
malposition, or to a laceration, the surgeon or gynecologist may 



376 STERILITY: ITS CAUSES, PREVENTION, CURE 

be able to effect a cure. With the reposition of the displaced 
organs, with the repair of the lacerated structures, or with the 
removal of the inflamed tissues, conception may occur. If a 
leucorrheal discharge be treated as described in .Chapter 
XXXIII it may cease to be a factor in producing barrenness. 

Sterility, due to the presence of a general disease, may 
disappear with the cure of the disease. When it is due to un- 
healthy modes of life the woman herself may do much toward 
relieving the condition. She should lead a healthy life accord- 
ing to the rules laid down in the earlier chapters of this book. 
Often a change of air and scenery is of grcst benefit. Women 
who are very fat should take sufficient exercise and live; on an 
appropriate diet, both of which will be prescribed by their 
physicians in accordance with the individual requirements of 
their cases. The cure is not far to seek in women addicted to 
the use of alcohol. Matthews Duncan has described the case 
of an intemperate woman who was sterile for many years, but 
who became pregnant on abstaining from drink. Moderation 
should be observed in the marital relations and all bad habits 
must be avoided. 

The observance of the above precautions may be rewarded 
by the blessing of offspring in a hitherto childless marriage. 



CHAPTER XXXVII. 

THE CAUSES OF DISEASES PECULIAR 

TO WOMEN. 



Neglect of Hygienic Rules: Lack of proper exercise; Improprieties of dress; 
Improper food; Want of sufficient rest. The Development of the Mind 
at the Expense of the Body: Evils in the modern system of education; 
The girl's health given little consideration. Imprudence During Menstru- 
ation.. Mismanagement During and After Child-birth. Artificial Termina- 
tion of Pregnancy. Unhygienic Marital Relations. Chronic Constipation. 
The majority of the conditions causing women's diseases are preventable. 
able. 



"Find out the cause of this effect, 
Or rather say, the. cause of this defect, 
For this effect defective comes by cause." 

— Shakespeare, 

HERE is no question that many of the diseases from 
which women suffer occur through ignorance. Never 
having been informed as to the precautions she should 
observe in her daily life, a woman frequently falls into 
errors which in time lead to serious trouble. Knowledge, there- 
fore, is the greatest aid to prevention. Familiarity with the 
causes of the diseases to which she is subject would certainly 
render a woman better able to avoid them. These causes may 
be summed up as : (i) Neglect of hygienic rules ; (2) excessive 
mental development at the expense of physical development ; 
(3) imprudence during menstruation; (4) imprudence and 
neglect during and after childbirth ; (5) the artificial termina- 

877 







378 THE CAUSES OF DISEASES PECULIAR TO WOMEN 

tion of pregnancy; (6) unhygienic marital relations; and (7) 
chronic constipation. 

NEGLECT OF HYGIENIC RULES. 

Failure to live hygienically is certainly a preventable cause. 

Lack of Proper Exercise. — The majority of the female 
sex fail to realize how essential to health is daily exercise in the 
open air, and they neglect this important means of keeping the 
muscles and internal organs in a normal condition. In the 
cities many of the girls and younger women indulge in various 
sports, such as golf, tennis, bowling, rowing, and so forth, but 
others, especially the older women, remain indoors, confining 
themselves to the close atmosphere of the house. There are 
some who even do almost no walking at all and who seldom 
engage in any work involving the least exertion. In the coun- 
try districts women commonly take even less exercise than they 
do in the city; the farmer's wife and daughter spend most of 
their time in stuffy and overheated rooms. Those who neglect 
to take sufficient exercise often suffer in consequence from 
obesity, loss of appetite, indigestion, chronic constipation, ill- 
defined pains and menstrual irregularities. 

On the other hand, if the exercise be excessive, or be in- 
dulged in at the wrong time, it may itself lead to conditions of 
ill health. During the menstrual period a woman should avoid 
all exercise and consequently should not indulge in violent 
games, in dancing or in surf bathing. Violent exertion of any 
kind is always dangerous to a pregnant woman. 

Improprieties of Dress. — Faulty methods of dressing are 
responsible for many diseased conditions. The body frequently 
is insufficiently protected from cold. Undergarments are often 
made of unsuitable material and so fashioned that they leave 
the neck, chest, arms or lower limbs unprotected. Open work 
stockings and thin slippers are frequently worn. The dress is 
often cut low, so that the neck and shoulders are left bare. 
When a person thus insufficiently clad is exposed to cold, or to 



THE CAUSES OF DISEASES PECULIAR TO WOMEN 379 

a sudden change of temperature, as in leaving a heated ball- 
room for the cool air of a hall or veranda or in stepping into 
the yard from a hot kitchen, the skin becomes chilled and the 
person "catches cold;" in other words, the blood-vessels in 
the skin contract, driving the blood into the internal organs, 
and thereby causing them to become congested. The effects 
of such exposure are much more serious when it occurs dur- 
ing menstruation, as at this time the organs already contain 
an excessive amount of blood. 

The constriction of the modern female dress, as typified by 
the corset, does harm in many ways; it interferes with the 
proper functions of the organs in the chest, abdomen and pelvis. 
The restriction it causes to the proper expansion of the lungs 
may in time lead to consumption. The heart is frequently 
slightly displaced, and in consequence often becomes very irrita- 
ble, producing symptoms at the slightest additional stimulus. 

Tight lacing and the suspending of heavy clothing from 
the waist affect the breathing in still another way by impairing 
the abdominal respiration. Moreover, the abdominal walls 
are weakened and the abdominal organs are pressed down by 
this injurious force. The stomach becomes altered in size 
and its digestive powers are interfered with. It, as well as 
other of the abdominal organs, may be dragged out of place. 
The effect of these changes will be a chronic dyspepsia involving 
both the stomach and the intestines and associated with chronic 
constipation and distention of the bowels. The wearing of 
tight corsets has even led in some cases to the occurrence of 
appendicitis. 

Compression exerts no less serious an effect on the pelvic 
organs. It may cause the womb to be displaced backward and 
downward, and, through interference with its circulation, to 
become chronically congested and later become the seat of other 
and more serious disorders. The ovaries and Fallopian tubes 
are likewise crowded out of their normal position by tight 



380 THE CAUSES OF DISEASES PECULIAR TO WOMEN 

lacing. During pregnancy, constriction of the abdomen may 
produce a miscarriage or may affect the shape and position of 
the child; it always renders the occurrence of varicose veins 
more liable during this period, as does also the wearing of 
circular garters. 

Improper Food. — Improper food has its share in causing 
disease. In the first place, the maintenance of the general 
health is necessary for making one able to combat disease. To 
keep the body strong and well, good, nourishing food is re- 
quired. Indeed, many painful conditions of the generative 
organs are due to an impoverished state of the blood caused by 
malnutrition. It is important, therefore, for every woman to 
eat a sufficient amount of good food properly prepared. It has 
been said that the American woman in the rural districts is half 
starved, not because she does not get enough to eat, but because 
she does not eat the kind of food that makes rich blood and 
tends to build up the tissues of the body. The farmer's wife, 
for instance, instead of being stout and of good color, is often 
pale and thin. This is in part due to the too frequent use of the 
frying pan, to the eating of salt fish and meats instead of fresh 
foods, to the drinking of coffee and tea instead of milk and 
cocoa, and above all to the constant use of pies and hot bread. 
In the large cities, on the other hand, women eat too much, and 
in consequence develop dyspepsia, constipation, and allied dis- 
orders. It is here that the late eating and drinking among the 
fashionable people is productive of so much chronic trouble. 

Want of Sufficient Rest. — Many nervous disorders occur 
from women not taking sufficient rest. Many young girls go 
out night after night during a whole winter's gay season, com- 
ing home from a dance often at four or five o'clock in the 
morning. With the using up of the nervous energy which she 
needs for resisting disease, a society woman frequently becomes 
the prey of various disorders. 

Nor is the society woman the only offender. Many work- 




A FAMOUS BEAUTY BY A FAMOUS PAINTER. 

It is the duty of woman to add to beauty, given by nature, the 
expression and sweetness which comes by cultivation. 



THE CAUSES OF DISEASES PECULIAR TO WOMEN 381 

ing girls, after standing before a loom or behind a counter 
from early morning till sundown, will go out again after supper 
and will not return until late at night. The mother of a large 
family after a hard day's work will often sit up until midnight, 
sewing. It is no wonder, therefore, that with this waste of 
her vital force, a woman loses her inborn ability to combat dis- 
ease and soon succumbs to one of the many diseases peculiar to 
her sex. 

THE DEVELOPMENT OF THE MIND AT THE EXPENSE OF THE 

BODY. 

Every physician sees the injurious effect upon the girl's 
health of the modern system of education. Mothers whose eyes 
are open should also see it ; yet the melancholy fact remains that 
few do. Even female school teachers seldom recognize or 
admit that such a state of affairs exists. The difficulty seems 
to the writer to lie in the attempt to teach too much in too short 
a time. With the continual advance of knowledge there nat- 
urally is more to be learned in each succeeding decade. This 
fact has been met differently by the college and by the school. 
In the medical college, for instance, when the increase of science 
necessitated the addition of extra subjects, the course was ex- 
tended from two to three, and then to four years. To-day, in 
fact, some universities will admit to the medical course only 
those who have completed four years in the academic college 
department, thus making the whole course of study after leav- 
ing the high school seven or eight years. In the schools, how- 
ever, the length of the course remains the same, despite the 
constant additions to the number of subjects taught and to the 
amount to be learned in each branch. This has resulted in a 
course of education of too great severity, which demands of 
growing girls too close an application to their studies. The 
girl must spend the whole morning and part of the afternoon 
in a crowded and often badly ventilated class-room, frequently 



3S2 THE CAUSES OF DISEASES PECULIAR TO WOMEN 

with her body in a cramped position. During the rest of the 
day she must remain indoors at her books, preparing the les- 
sons for the morrow. 

With all this attention to the mental advancement of the 
girl, little or no provision is made for her physical development. 
Throughout this whole system of education the health of the 
girl is given little consideration. There is no attempt to regu- 
late the amount or character of the work in accordance with the 
health, condition, or temperament of the individual. The 
question of sex is utterly disregarded. The girl receives no 
special care or attention at the time of puberty, or at the men- 
strual periods, nor are her studies lightened at these times. 
Instead, Nature's demand for physical and mental rest is met 
with the teacher's urging on the unfortunate child and endeav- 
oring to make her apply herself more closely to her lessons. 
It is no wonder, therefore, that with the girl's rapid mental 
development comes a condition of general ill-health with im- 
poverished blood, poor physique, and a marked tendency to 
disorders and disease of the generative organs. Prominent 
among such disorders are pain and irregularity attending the 
menstrual function. Professor Goodsell thus expressed his 
views on this important subject: 

"In one word, it is to the present cramming and high- 
pressure system of education, together with its environment, 
that I attribute much of the menstrual derangements, the 
sterility, the infecundity of our women, the absence of sexual 
feeling, the aversion to maternity, the too often lingering 
convalescence from a first labor, which is frequently the only 
one, and the very common inability to suckle their offspring. 
From this cause come most of my unmarried patients with 
nerve prostration, with their protean mimicry of uterine symp- 
toms — unmarried often because they are not well enough to 
wed. If woman is to be thus stunted and deformed to meet the 
ambitious intellectual demands of the day, if her health must be 



THE CAUSES OF DISEASES PECULIAR TO WOMEN 383 

sacrificed upon the altar of her education, the time may come 
when, to renew the worn-out stock of this Republic, it will be 
needful for our young men to make matrimonial incursions 
into lands where educational theories are unknown." 

IMPRUDENCE DURING MENSTRUATION. 

There are preventable causes other than those men- 
tioned. A considerable proportion of women's suffer- 
ings is caused by carelessness, imprudence and neglect 
during the menstrual period. As has been shown, the 
womb and ovaries become greatly congested for several 
days in every month, during which time the nervous 
system is in a state of unusual excitability. Instead of keeping 
the congested organs at rest, protecting the body from cold 
and relieving all strain from the mind and nervous system, 
women will often exhibit an utter disregard for all hygienic 
precautions. They will go out in the most inclement weather, 
often insufficiently clad and wearing thin slippers. Seldom 
during this period is any difference observed in the daily 
routine, whether of business, housework, school or society. 
Girls indulge in skating, dancing, and long walks during such 
a time without giving the matter a second thought. Some 
women even go so far as to try to check the flow by taking a 
cold general bath or a cold vaginal douche when their condition 
interferes with their plans for work or pleasure — a most dan- 
gerous procedure. In fact, many diseases, both acute and 
chronic, are caused by the neglect through ignorance, reck- 
lessness, or necessity of proper precautions at the time of the 
menstrual periods. 

MISMANAGEMENT DURING AND AFTER CHILD-BIRTH. 

The chronic invalidism common among married women 
results in most cases from bad management, imprudence, care- 
lessness or neglect either at the time of labor or during the 



384 THE CAUSES OF DISEASES PECULIAR TO WOMEN 

weeks immediately following it. Most frequently it is due to 
lacerations received during the passage of the child and which 
have never been repaired, and in some instances not even rec- 
ognized. This mismanagement is more apt to occur when a 
midwife has been employed instead of a physician. Midwives, 
as a rule, are unable to recognize any but the most conspicuous 
injuries, and in many instances they are utterly incompetent to 
prevent lacerations. When a laceration is not repaired it may 
lead to many of the conditions from which women suffer. An- 
other cause of disease having its origin at this time is the 
absence of surgical cleanliness on the part of the nurse in con- 
nection with everything that pertains to her patient. 

Imprudence during the puerperium is also a frequent cause 
of women's diseases. After a labor at term the womb is six 
weeks in returning to the normal. In order that this process 
may proceed uninterruptedly to a perfect conclusion, rest is 
essential. One of the ill effects, therefore, of a woman's get- 
ting up too soon after child-birth and resuming her household 
duties is the failure of the womb to diminish in size and to 
become restored to its original condition; instead, it remains 
enlarged and congested, frequently undergoing a chronic in- 
flammation. At this same time the membrane lining the uterus 
is rendered more liable to disease and becomes very easily 
affected. Then also, when a woman rises too soon after con- 
finement, the large and heavy womb is liable to be displaced, 
especially as the ligaments supporting it have been weakened 
and stretched. If the abdominal compress is misapplied after 
labor — placed over the womb instead of above it — it will press 
this organ backward and thus cause a backward displacement. 

ARTIFICIAL TERMINATION OF PREGNANCY. 

Seldom is pregnancy terminated by artificial means with- 
out a long train of diseases following. Frequently the criminal 
operation ends in death. Chronic invalidism always results. 



THE CAUSES OF DISEASES PECULIAR TO WOMEN 385 

Moreover, in such cases, to the risks of an ordinary miscarriage 
is always added the danger of blood poisoning. \ 

UNHYGIENIC MARITAL RELATIONS. 

A woman's general health suffers and her generative 
organs become diseased when the normal relations are dis- 
turbed. Excess not only exhausts the nervous system and 
leads to a condition known as neurasthenia, but it also causes 
chronic congestion of the organs, with resultant abnormalities 
and disease. The various methods adopted to prevent con- 
ception are all injurious ; their traces can be seen in the nervous 
breakdowns and local diseases that inevitably follow their use. 

CHRONIC CONSTIPATION. 

It is a well-known fact that the great majority of women 
are habitually constipated. Some may not have a passage of 
the bowels for weeks at a time. The large, hard, fecal masses 
present in the rectum act mechanically by pressing on the veins 
coming from the generative organs ; this interference with the 
circulation causes congestion and the diseases usually following 
it. At the same time the poisons in the fecal discharges, that 
should be expelled from the intestines, are being slowly absorbed 
back into the blood, and thus give rise to many and varied symp- 
toms and often prevent proper general development. 

THE MAJORITY OF THE CAUSES OF WOMEN'S DISEASES ARE 

PREVENTABLE. 

This enumeration of the causes that give rise to the dis- 
eases from which women suffer brings out the important fact 
that the majority of them are preventable. It shows how false 
is the idea so prevalent with the female sex that they have an 
inherent tendency to disease of the generative organs, and may 
be considered lucky if they escape. The statement may safely 
be made that the number of diseases that are unavoidable is 

25 



386 THE CAUSES OF DISEASES PECULIAR TO WOMEN 

small compared with that large number of diseases for which 
the woman is herself directly responsible. Carelessness and 
indiscretion, the result usually of ignorance, cause the greater 
amount of women's suffering. It is to be hoped that, with a 
knowledge of the causes of the diseases peculiar to her sex, a 
woman will be better able to avoid them. 



CHAPTER XXXVIII. 

THE PREVENTION OF THE DISEASES 
PECULIAR TO WOMEN. 



The prevention of disease lies in the woman's hands; When disease has 
occurred a physician must always be consulted. The Importance of Keep- 
ing the General Health at its Highest Point. Attention must be paid to the 
manner of supporting the clothes and to the mode of life generally, espe- 
cially during the period of puberty. Many diseases are prevented by the 
Observance of Surgical Cleanliness During a Labor or Miscarriage and by 
the exercise of prudence and care afterward. The Prompt Repair of all 
Lacerations occurring during child-birth would be the greatest factor in 
banishing invalidism from womankind. The Question of Personal Purity 
and of marrying only one of good moral character. 

"A wise physician, skill'd our wounds to heal, 
Is more than armies to the public weal." 

— Pope. 

[i|lTlT is in preventing disease that a woman can utilize what 
knowledge of hygiene she may possess. When once 
the disease has occurred, the advice of a competent 
physician must he sought. On the first evidence of 
anything being wrong a woman should always consult a reli- 
able physician. No one but a trained physician has the ability 
to recognize what condition is present, and none other can 
advise the appropriate treatment. An enumeration of the 
symptoms that arise from disease of the womb or Fallopian 
tubes or other organs would serve merely to make a woman 
introspective and apprehensive, without rendering her capable 
of properly interpreting any symptoms she might notice in 

387 



388 PREVENTION OP DISEASES PECULIAR TO WOMEN 

herself. How, in the absence of medical advice, the various 
symptoms that may occur can be temporarily relieved, has 
already been told in Chapter XXXIII. Whether or not she 
put those suggestions into practice, a woman should always 
place herself under the care of her physician. Even when the 
application of the home remedy has temporarily caused the 
symptoms to disappear, the diseased condition that produced 
them may still remain and may continue to grow progressively 
worse. When a woman puts herself under a doctor's care she 
must faithfully follow his directions. The physician in attend- 
ance is familiar with the actual conditions present, and he 
knows best what should be done. Any suggestions as to treat- 
ment that might appear in a book such as this would be super- 
fluous to a woman who is under competent medical supervision. 
On the other hand, the sufferer who has put off seeking pro- 
fessional advice might be led to still further postpone this 
necessary action, should she read of any methods of treatment. 
Many women die before their time because, instead of going 
at once to their family practitioner, they try a certain patent 
medicine or adopt some gratuitous suggestion of a well-mean- 
ing but ignorant neighbor, until finally the disease has acquired 
such a hold that a cure is no longer possible. 

PREVENTION BETTER THAN CURE. 

Many diseases of women, as has been said, are pre- 
ventable. Consequently, in connection with the description 
given in Chapter XXXVII as to the causes of the more impor- 
tant diseases, instruction as to how these diseases can be pre- 
vented may prove of value. According to an old adage, "An 
ounce of prevention is worth a pound of cure." Not only, how- 
ever, is it much easier to prevent a disease than to cure it, but 
the reward of prevention is the avoidance of suffering, while 
cure merely puts an end to it. So, with prevention, the gain is 
greater although the expenditure is less; yet, despite this fact, 



PREVENTION OF DISEASES PECULIAR TO WOMEN 389 

having to act with caution always seems a hardship to a well 
person. It is a trouble to be careful ; and inasmuch as a woman 
may possibly escape sickness despite her imprudence, she often 
is willing to run the risk. Than this there can be nothing more 
foolish. To live hygienically is not so much more difficult or 
inconvenient than to live unhygienically, if one but knows how 
to go about it. Yet through ignorance a woman may, by her 
imprudence, actually invite disease. 

Some grave conditions may often be prevented by prompt 
attention to their earliest symptoms. At the first evidence of 
disease a woman should immediately be placed under medical 
care. When the cause of a disease is known, avoidance or 
removal of the cause will often prevent the disease. Hence a 
thorough knowledge of the causes of women's diseases, as 
given in Chapter XXXVII, is needed for intelligently apply- 
ing the methods of prevention. 

THE NECESSITY OF PRESERVING THE GENERAL HEALTH. 

There are some diseases, however — such, for instance, as 
cancer — whose cause is not yet known. In such cases the best 
preventive consists in the preservation of the general health 
and the development of a strong bodily constitution. It is the 
belief of the author that every one is endowed with the power 
of resisting disease, and that this power is strongest when the 
general health of the individual is at its best, and weakest when 
the general health is lowered. To his mind, the most effective 
method of preventing such a disease as cancer or tuberculosis 
is to keep the general health at the highest point bv means of 
the hygienic measures described in Chapters II to YII of this 
book. The same is true of the various chronic conditions, 
which are more liable to obtain a hold on those whose general 
health is run down. 

There are other conditions, including the various displace- 
ments of the womb, which may often be prevented by the observ- 



390 PREVENTION OF DISEASES PECULIAR TO WOMEN 

ance of hygienic principles. If a girl is allowed to grow up strong 
and healthy, she probably will escape many distressing com- 
plaints. Although the bending forward of the womb, or ante- 
flexion, as it is called, sometimes exists from birth and occa- 
sionally is the result of imperfect development during child- 
hood, its occurrence is always favored by improper dress and 
improper modes of life during the period of puberty. This 
neglect of hygiene may even be the sole cause of the condition. 
A backward displacement of the uterus also is more liable to 
occur when the clothing is supported from the waist, and 
much less so when it is supported from the shoulders. 

THE OBSERVANCE OF PRUDENCE AND CARE DURING AND 
AFTER A LABOR OR MISCARRIAGE. 

There are many diseases of women which have their 
origin in a labor or miscarriage that was not properly man- 
aged or in which the woman was imprudent. The prevention 
of an acute inflammation of the womb, for instance, lies in the 
observance of surgical cleanliness by physician, nurse and 
patient both during and after a labor or miscarriage. If every- 
thing — hand, instrument or dressing — that touches the private 
parts is surgically clean, and if the directions given in Chap- 
ters XIX, XXII and XXV are strictly observed, such a com- 
plication will be prevented. This observance of surgical clean- 
liness during and after a labor or miscarriage will also prevent 
acute inflammation of the Fallopian tubes, which is a septic 
infection or poisoning usually due to an extension from an 
acutely inflamed womb. This condition consequently may 
occur after a criminal abortion, miscarriage or labor in which 
infection has occurred. It frequently leads to peritonitis or 
blood poisoning, which may go on to a fatal termination, or 
may require a dangerous operation in order to save the woman. 
This is why any one who submits to a criminal abortion runs 
the risk of losing her life. 



PREVENTION OF DISEASES PECULIAR TO WOMEN 391 

Many cases of displacements of the uterus and of prolapse 
or falling of the womb would be prevented by the observance 
of prudence and care after a labor or miscarriage. Leaving 
the bed or going to work too soon after one of these occurrences 
is the most frequent cause of backward displacement of the 
womb. Faulty application of the compress under the binder 
after labor may also cause this condition if, instead of applying 
it above the top of the womb, the nurse places the compress 
directly in front of it, thus crowding the womb backward. 
Getting up too soon after confinement also causes prolapse or 
falling of the womb, due to the pulling of the womb — at this 
time large and heavy — on the overstretched ligaments, which 
are unable to stand the strain. 

THE PROMPT REPAIR OF LACERATIONS. 

The one thing that would do most toward banishing inva- 
lidism from womankind is the prompt repair of all lacerations 
occurring during childbirth. An unrepaired laceration or tear 
that has occurred during labor is another common cause of a 
backward displacement of the womb. A tear or laceration 
which has occurred during childbirth and has not been 
repaired is the most frequent cause of falling of the womb, 
although the prolapse is more liable to occur or to grow worse 
if the ligaments are weakened by too frequent labors, by old 
age or by a condition of general feebleness. Heavy lifting or 
hard manual labor may also help to produce or increase the 
prolapse in the presence of any of the above conditions. Cer- 
tain incurable diseases are sometimes prevented by the prompt 
repair of a laceration occurring during childbirth. The cause 
of cancer, for instance, has never been discovered. Physicians 
have noticed, however, that it frequently begins at the site of 
an old tear of the neck of the womb which has never received 



392 PREVENTION OF DISEASES PECULIAR TO WOMEN 

attention. One way of preventing cancer, therefore, is to have 
promptly repaired any laceration that may have occurred in 
the neck of the womb. 

PERSONAL PURITY A FACTOR IN THE PREVENTION OF DISEASE. 

Personal purity is the chief protection from pus tubes and 
other chronic or acute conditions having their origin in gon- 
orrhea. Many innocent women,, however, are made to suffer 
and even die for the faults of others. When a young man 
sows his wild oats, it is usually his future wife who must reap 
them. For her own protection, therefore, a girl should not 
marry one whose morals are lax in this respect. 



CHAPTER XXXIX. 
ACCIDENTS AND EMERGENCIES. 



Foreign bodies in the eye; in the ear; in the nose; in the throat. The effect 
of heat. Burns and scalds. Treatment of sunburn. Sunstroke or heat stroke. 
Heat exhaustion. The effects of cold. Freezing and its treatment. Frost- 
bite—treatment of. Chilblain. The effect of injuries. The condition of shock. 
Contusion or bruises. Wounds. Arrest of hemorrhage. Removal of foreign 
bodies from a wound. Cleansing the wound. Closing and dressing a wound. 
Keeping the part at rest. Poisoned wounds — by germs — stings of bees, wasps 
and hornets — snake-bites — bite of a mad dog. Sprains. Dislocations. Fract- 
ures. The action of poisons. Burns with poisons. Drowning. 



iT N addition to knowing how to live hygienically and avoid 
disease, a woman should be prepared to meet any 
emergency. Prompt action and coolness, which is born 
of knowing what to do, tends to relieve suffering and 
may be the means of saving life; it will always render more 
effective the skilled medical assistance when it finally arrives. 
The aim of this chapter is to teach the proper thing to do in 
all the accidents and emergencies that may occur. These are 
many and varied, including wounds and injuries of all kinds, 
the effects of heat and cold, poisoning, drowning, and the pres- 
ence of foreign bodies in the eye, nose, throat and ear. 

FOREIGN BODIES IN THE EYE. 
Nature has a way of her own of removing particles from 
the eye. The entrance of a foreign particle is usually followed 
by a full flow of tears, which tends to wash out the foreign body 
over the cheek or through the tear duct into the nose. Rubbing 
the well eye causes the tears to flow in both eves, and thus 
helps to wash out the body without further irritating the sore 
eye. Blowing the nose draws the tears, with the particle 



394 ACCIDENTS AND EMERGENCIES. 

floating in them, down to the tear canal. Opening both eyes 
in a basin of clean water and with the eyes open, moving the 
head about, up and down and from side to side, will often wash 
the particle out of the eye. 

In removing a foreign body from the eye of another, one 
must first locate it. The eye should be examined in a good 
light. The lower lid is drawn down with a finger and every 
portion of its inner surface is carefully scanned. If the particle 
is seen it may be removed by drawing across it a small camel's- 
hair brush, a piece of clean cotton, or the corner of a clean, soft 




nandkerchief. If nothing is seen on the lower lid, the upper 
lid must be examined. The patient being seated on a chair 
with the light shining on the eye, the lashes are grasped 
between the thumb and first finger of the left hand and the lid 
is drawn down and away from the eye-ball. A finger of the 
right hand (or a pencil, pen-holder, match-stick, or a knitting 
or crochet needle) is placed upon the lid about a third of an 
inch from the edge and parallel to it, and, the patient being 
asked to look down, the lashes are pulled upward so as to turn 
the lid back up over the finger or pencil. While the lid is being 
held back by the left hand it is thoroughly examined, and any 



ACCIDENTS AND EMERGENCIES. 



395 



speck seen is removed by drawing a piece of cotton or the 
corner of a clean handkerchief or a brush over it. 

When nothing is found on either lid the eye-ball itself must 
be carefully examined with the light striking it at different 
angles, and any foreign body in a similar manner discovered 
should be removed. 




FOREIGN BODIES IN THE EAR. 

In most cases where a foreign body has entered the ear 
more harm is done by ignorant meddling than by the object 
itself. Unless one knows exactly what to do, it is always best 
to make no attempt to remove the substance, but to wait until 
skilled assistance can be obtained. 

When a live insect crawls or flies into the ear there are 
a number of safe things that can be done. Water, salt-water 
(a teaspoonful of table salt to a tumblerful of water), sweet 
oil, or castor-oil poured into the ear will smother the insect and 
float it out. When a live insect has entered the ear, it may 
sometimes be tempted to crawl out if the ear be turned at once 
toward a bright light. If the insect is not coaxed or floated 
out with one of these methods, the car should be gently syringed 



396 ACCIDENTS AND EMERGENCIES. 

with warm water or warm salt-water. If this fails to remove 
the insect, the aid of a physician should be sought. 

In endeavoring to remove peas or beans from the canal 
of the ear syringing must not be resorted to; water makes them 
swell and would thus render them harder to extract. 

When a hard object, such as a bead, marble, button, or 
other mineral body becomes lodged in the ear, the greatest care 
must be exercised. It will often drop out if the head be inclined 
with the ear downward and the lobe pulled outward and back- 
ward so as to straighten the canal. A teaspoonful of olive oil 
poured into the ear will often aid in its expulsion. In such a 
case, if the head be turned over suddenly, the object will often 
roll or slide out. If, while the ear is turned downward, it be 
rubbed in front with a rotary motion, a small body may fall 
out. Syringing the ear thoroughly with warm water in the 
manner previously described will sometimes cause the object 
to be expelled. A popular method is to place a brush, loaded 
with glue or other adhesive fluid, in contact with the foreign 
body, allowing it to remain until firmly adherent; whereupon 
the brush is pulled upon until it comes out with the object stuck 
fast to it. In no case should an instrument be employed. It 
should be remembered that seldom is serious harm caused by 
a foreign body, even if it lie undisturbed for months or years. 
Poking and prying only wedges the body in tighter, and may 
even force it throughthe drum membrane. 

FOREIGN BODIES IN THE NOSE. 

The use of forceps and other instruments in an endeavor 
to extract a foreign body from the nose is attended with con- 
siderable damage; the object may be pushed farther in and 
wedged tighter, and the delicate structures of the nose may be 
injured. 

When obstructed by a foreign body the nose should be 
blown with some force, the free nostril being closed by pressure 
with the finger. Sharp expulsive efforts may occasionally be 



ACCIDENTS AND EMERGENCIES. 397 

produced in a child by having it take a deep breath and then 
giving it a smart blow on the back. The offending substance 
can sometimes be dislodged in the act of sneezing, which may 
be excited by giving snuff or tickling the inside of the nostril 
with a feather or straw or something similar. It has been 
advised that one person hold the child while another closes the 
free nostril with a finger and blows sharply and quickly into 
the child's mouth. The object may be washed out by means of 
a syringe or a nasal douche. If these methods fail, but better, 
before they are tried, a physician should be consulted. As a 
rule little harm is done by waiting. 

FOREIGN BODIES IN THE THROAT. 

If the foreign body is in the upper throat or pharynx it 
may often be removed by the finger." If lower down, either in the 
air passages or in the oesophagus, it may sometimes become dis- 
lodged by vomiting, excited by tickling the throat deep down 
with a feather. 

When the object is in the larynx or wind-pipe a physician 
should be summoned promptly. Pending his arrival various 
methods may be attempted for getting rid of the substance. It 
is sometimes possible to excite an effective cough by bending 
the body well forward and having some one strike the back 
sharply during each successive act of coughing. Striking the 
chest with the head down may likewise add force to the cough. 
Babies and small children may be held up by the legs with 
their heads downward. A smooth object, such as a pebble or 
a coin, may often be made to roll into the mouth if the head 
be lowered backward. This may be accomplished by sitting 
upon the arm of a sofa or large chair and bending backward 
toward the floor. Another way is to sit on the edge of a bed 
with the legs thrown across the bed and then bend the body 
backward until the head touches the floor. 

THE EFFECTS OF HEAT. 

The action of heat may produce burns, scalds, sunburn, 
sunstroke, and heat exhaustion. 



398 ACCIDENTS AND EMERGENCIES. 

BURNS AND SCALDS. 

Burns are caused by the action of dry heat. (The burns 
that are caused by chemicals will be discussed under "The 
Action of Poisons/') Hot liquids and steam produce scalds. 

Burns and scalds act in two ways: they cause a shock to 
the whole system and they injure the parts affected. The shock 
may itself be severe enough to cause death. It is shown by a 
condition of collapse, with a cold skin, weakness and shallow 
breathing. The effect of the local injury depends not only 
upon its severity, but upon the extent of the surface involved 
as well. If the burn or scald covers more than two-thirds of 
the body death is certain to follow, probably within two days. 

In connection with such accidents it is important to know 
what to do when a person's clothes are burning, how to remove 
the clothes, and how to treat the burn itself and to counteract 
the effects of the shock. 

To Extinguish Burning Clothing. — When one's clothes 
are on fire the best thing to do is to wrap the burning part 
closely in a rug, mat, shawl, blanket, carpet, overcoat, or any 
woolen thing that will smother the flames. If nothing of the 
kind be within reach, one should lie down on the ground or 
carpet and roll about there in order to extinguish the flames 
by pressure, at the same time endeavoring to crush the burning 
garment with the hands. 

To extinguish burning clothing on another, one should 
wrap him tightly in a blanket or rug or something similar, and, 
throwing him to the ground, roll him about there until the 
flames are put out. When the flames have been extinguished 
the person should be drenched with water to prevent the smoul- 
dering clothes from continuing to burn into the flesh. 

The Immediate Treatment in Scalding. — In a case of 
scalding, either by boiling liquid or live steam, cold water should 
be poured freely over the person and his clothes. 

How to Remove the Clothing. — In removing the clothing 



ACCIDENTS AND EMERGENCIES. 399 

the greatest gentleness and care must be exercised. The gar- 
ments must be cut with a large, sharp pair of scissors, or a 
sharp knife, in such a manner that they will fall off of them- 
selves. They must not be pulled or torn, nor must the body be 
moved or disturbed. No attempt should be made to save any 
part of the clothing at the expense of gentleness. If any part of 
the clothing adheres to the skin it should be allowed to remain, 
the rest of the garment being freed by cutting round the 
adherent portion with a sharp knife or sharp scissors. It may 
be possible later to loosen the adherent portion by moistening 
it with a solution of salt and water and thus remove it. 

Treatment of Slight Scalds and Burns. — Slight burns or 
scalds should be treated by applying a clean cloth soaked in a 
solution of bicarbonate of soda (baking soda) prepared by 
adding a heaping teaspoonful of soda to a pint of water, or in 
a solution of phenol sodique in the proportion of i to 8. Of 
the oily substances that may be employed, carbolated vaseline, 
which, however, should not be used on the face, is the best and 
safest. A mixture of equal parts of linseed oil and lime water, 
called Carron oil, is not so cleanly, but it allays the pain. Any 
other available oil, such as olive oil, castor oil, lard oil, or 
kerosene, may be used, or, in the absence of anything better, 
the part may be smeared with butter, washed lard, grease or 
the raw white of egg. 

Treatment of Severe Scalds and Burns. — In every case 
where a burn or scald is severe a physician must be summoned. 
Pending his arrival, stimulants, such as whisky or brandv, may 
be given in small quantities to combat the shock to the nervous 
system. If the pain is very great, it is justifiable to administer 
laudanum, thirty drops to an adult, and as many drops to a 
child as its years of life number. If the patient has a chill he 
should be placed in a warm bath kept at a temperature of too 
degrees Fahrenheit. At times it may be necessary to treat the 
burn itself without waiting for the doctor. Any blisters that 



400 ACCIDENTS AND EMERGENCIES. 

are present should be opened with a needle that has been boiled 
or held in a flame; the blister being punctured at one edge, so 
that after the water runs out the raised skin will fall down upon, 
and thus protect, the delicate and sensitive skin beneath. In ex- 
tensive burns, where the skin has been destroyed or broken, and 
hence germs can gain entrance to the parts beneath, it is very 
important that surgical cleanliness, as explained on pages 198 
and 199, be strictly observed in dressing the parts. Conse- 
quently only in the absence of anything better should the 
various household remedies previously described be employed. 
The safest dressing is the mixture of a teaspoonful of carbolic 
acid, two tablespoonfuls of glycerine and a pint of olive oil, 
applied on strips of muslin. 

THE TREATMENT OF SUNBURN. 

The burns caused by exposure to the sun's rays may be 
treated by dusting on the painful parts pure bicarbonate of 
soda (baking soda) or any good talcum or toilet powder. 
Another method is to moisten the skin frequently with a solu- 
tion of baking soda in the proportion of a heaping teaspoonful 
to a pint of water, or a 1 to 8 solution of phenol sodique, or a 
lotion of lime-water containing two drops of carbolic acid to 
the ounce. 

SUNSTROKE OR HEAT STROKE. 

Sunstroke occurs chiefly in persons who are exposed to 
the sun while working very hard. It affects practically only 
those who have been drinking intoxicating liquors. 

The condition is not the same as heat exhaustion, which 
is described later, and its treatment is entirely different. 

The attack comes on with a feeling of pains in the head, 
dizziness and a sense of oppression, followed by loss of con- 
sciousness. The face is flushed, the breathing is labored, the 
pulse is full, and, most important of all, the skin is burning hot 



ACCIDENTS AND EMERGENCIES. 401 

and dry, there being no evidence of perspiration. A high fever 
is always present. 

The object of the treatment in sunstroke should be to 
reduce the temperature as rapidly as possible. The patient 
should be removed to a cool and airy place and laid in the shade 
with the head and shoulders raised. The clothing is then 
removed and cold is applied without a moment's delay. If 
possible, the patient should be placed in a tub of ice-water. 
Whether or not this can be done, the body must be rubbed with 
ice. An excellent plan is to wrap the patient in sheets kept wet 
and cold by constantly pouring ice-water on them or rubbing 
them with ice. Rectal injections, or enemata, of ice-water may 
be given by means of a fountain syringe. 

HEAT EXHAUSTION. 

Heat exhaustion is caused by prolonged exposure to high 
temperatures, particularly when combined with physical ex- 
haustion. There need be no exposure to the direct rays of the 
sun; the condition may come on at night. Men working in 
close, confined rooms, and especially those employed in engine 
rooms, are liable to be attacked. 

Heat exhaustion is a condition of extreme prostration and 
collapse, not of fever. In it the skin is cool and moist, the face 
is pale, and the pulse small. The breathing, though hurried, is 
usually easy, and the senses are retained. 

The object of treatment in heat exhaustion is stimulation. 
The patient should be removed to a cool apartment and laid down 
flat, without the head being raised. He may be given a hot 
bath. Small doses of whisky or brandy, well diluted, should 
be given freely. Ammonia in half-teaspoonful doses may also 
be administered. Cold is not applied to the surface in this 
condition. 

THE EFFECTS OF COLD. 
The effects produced by cold are of two kinds: The whole 

26 



402 ACCIDENTS AND EMERGENCIES. 

body may be affected, as in general freezing; a single part, 
such as the fingers or toes, may be acted upon, with the produc- 
tion of chilblain or frost-bite. 



FREEZING AND ITS TREATMENT. 

Freezing is usually caused by prolonged exposure to cold. 
While it is most apt to result when the degree of cold is intense, 
it may also occur in susceptible persons when the cold is by no 
means severe. Susceptibility to the effects of cold is increased 
by hunger, great fatigue, indulgence in alcoholic drinks, and 
any circumstance that impairs the general tone of the system. 

When a person has been frozen, even if apparently dead, 
he should be placed in a cool room and carefully undressed. 
The whole body should then be rubbed briskly but gently with 
snow or with flannel wrung out of tincture of camphor or dilute 
alcohol or whisky. At the same time, or while the rubbing is 
temporarily suspended, artificial respiration must be practiced, 
as described later under "Drowning."* As soon as the skin be- 
comes red and warm, showing that reaction is well established, 
and the breathing becomes natural, the body may be wrapped in 
warmed blankets and the temperature of the room may be 
gradually raised. An enema of brandy should be given to the 
patient, and mustard plasters should be applied over the heart 
and spine. As soon jas the patient can swallow he is given 
stimulating drinks, such as cold brandy or cold coffee, and as 
his condition improves hot drinks may be administered. 

FROST-BITE. 

Brief exposure to an intense degree of cold, or prolonged 
exposure to a lesser degree, produces frost-bite. The nose, 
lips, ears and fingers are the parts most often affected, but the 
cheeks, the chin, the feet and legs, and the hands and arms may 
be attacked. 

The first evidence of frost-bite is the production of a dusky 

* See page 417. 



ACCIDENTS AND EMERGENCIES. 403 

redness, accompanied by some tingling and pain. Upon further 
exposure to cold the part becomes pale and numb. With the 
application of warmth to a frost-bitten part a violent reaction 
occurs; the part reddens and swells, becoming the seat of a 
burning sensation or actual pain. In mild cases this swelling 
and redness disappear, as a rule, in a few days, although some- 
times the redness persists. When the frost-bite is severe, the 
part becomes purple and blisters form on the surface. In such 
cases gangrene may occur. 

Treatment of Frost-Bite. — The object in treating frost- 
bite is to prevent mortification by moderating the reaction, by 
which is meant the return from the intensity of cold to body 
warmth. The patient should be kept in a cold room, while the 
affected part is rubbed with snow or ice, or with towels soaked 
in ice-water. As the skin becomes warmer and the redness 
disappears, the part should be wrapped in cotton-wool. A 
physician should always be summoned, but the treatment just 
described must be practiced immediately without waiting for 
him. The subsequent treatment of a frost-bite, however, 
should be left to the physician, especially if mortification occurs. 

CHILBLAIN. 

Chilblain is a very common affection. It is a secondary 
rather than a direct effect of cold. It is produced not so much 
by exposure to intense cold as by sudden alterations in tempera- 
ture. It occurs when a part that has been chilled is suddenlv 
heated. People often get frosted feet when upon coming in 
from walking or skating in cold weather they at once put the 
feet to a hot fire. Warming cold fingers over a Maine tends to 
produce chilblain of the fingers. 

The members that are particularly liable to be affected are 
the toes, heel and instep; the fingers, ears and nose may also 
suffer. 

Chilblain usually appears as a local congestion. The part 



404 ACCIDENTS AND EMERGENCIES. 

becomes reddened, more or less deeply, and swollen, and is the 
seat of intense itching and burning. 

Approaching a fire or taking exercise is apt to cause a 
chilblain to become congested, whereupon it itches, tingles and 
stings. A person who has once had chilblains is very apt to 
experience a return of the affection upon even slight changes 
of weather. 

Treatment. — The affected part should be plunged into 
cold water and rubbed, or it should be rubbed with snow. It 
should then be painted with tincture of iodine or a weak solu- 
tion of nitrate of silver (5 grains to an ounce of water), or 
bathed with soap liniment. After this it should be wrapped in 
raw cotton. When inflammation occurs or ulcers form, medical 
advice should always be sought. 

A person subject to chilblain must regulate his life so that 
recurrences are not likely to happen. He must take regular 
outdoor exercise and must be careful not to stand before a fire. 
Every morning and evening he should take a general cold 
sponge bath (as described on page 38), followed by rubbing 
with alcohol and by frictions with a coarse towel until a good 
reaction is obtained. When the feet are affected it is important 
to keep the circulation through them free and to avoid conges- 
tion. The body heat must be retained about the legs and feet, 
which must not be allowed to become chilled. Woolen stockings 
should be worn, and tight circular garters must be forbidden. 
The shoes should be large and roomy. During the winter 
woolen stockings must be worn in bed ; it would be well to sleep 
with the feet upon a hot-water bag, bottle or can. 

THE EFFECTS OF INJURIES. 

Injuries may be of various kinds. They appear in the 
form of bruises, wounds, sprains, dislocations and fractures. 
After a severe injury the whole system is in a state of shock. 
As this condition may follow any one of the different forms of 



ACCIDENTS AND EMERGENCIES. 405 

injuries, it will be dfecussed before the latter are taken up 
separately. 

THE CONDITION OF SHOCK. 

Shock is a sudden depression of the vital powers arising 
from an injury or a profound emotion which paralyzes the 
blood-vessels, thus causing the blood to leave the brain. All 
severe injuries are accompanied by some degree of shock. 

A person profoundly shocked lies motionless and silent, 
although he will move when directed and answer when spoken 
to. His face is pinched, the countenance expressionless, with 
dull eyes and drooping eye-lids. The mind is usually dull or 
bewildered, and unconsciousness may be present. The skin is 
pale, cold and clammy, and may be bathed in cold perspiration. 
The pulse is feeble and irregular, the breathing shallow. 

Shock demands prompt treatment or death may follow. 
Therefore, no matter what the nature of the injury producing 
it, immediate efforts to combat this condition must be made 
while a physician is being sent for. The treatment consists in 
rest, the application of warmth and careful stimulation. 

The injured person should not be moved about much, but 
should be laid down either flat or with the head lowered and 
feet raised, unless this latter position makes him blue in the 
face. He should be well wrapped up in hot blankets if possible. 
Heat should tje applied to the whole body by means of hot-water 
cans, hot-water bottles, hot-water bags, hot bricks, hot stove- 
plates, or bags of hot salt, which should always be wrapped in 
flannel so as not to burn the patient. They should be felt from 
time to time to make sure they are not too hot. Mustard plasters 
may be placed over the heart, spine and shins. Hot drinks 
should be given — hot black coffee without sugar, or hot water 
— if they are retained. Small amounts of whisky or brandy 
should be added to the hot water, a teaspoonful of brandy in a 
tablespoonful of hot water being given at ten or fifteen minute 



406 ACCIDENTS AND EMERGENCIES. 

intervals for several doses. Aromatic spirits of ammonia in 
doses of half a teaspoonful in a little water may be given instead 
of the liquor. 

CONTUSION OR BRUISES. 

A contusion or bruise is an injury to the tissues beneath 
the skin, without damage to the skin itself. In the mildest 
forms, as seen in the ordinary bruise, small blood-vessels are 
ruptured, permitting the blood to escape into the part, where 
it undergoes certain color changes. The part at first is red, 
but soon becomes purple, black, green, lemon, and finally citron. 
This discoloration is seen most markedly in the eye-lids, as in 
the so-called "black eye." Swelling usually follows a contusion, 
due partly to the presence of blood and partly to an accompany- 
ing inflammation. The injury and the consequent swelling 
frequently give rise to some aching pain or a feeling of soreness, 
which rarely persist more than twenty-four hours, although the 
spot is usually tender for days. 

If shock is present, it should be treated first, as detailed in 
the preceding pages. 

The treatment of the contusion itself depends upon its 
severity. When serious symptoms are present, a physician must 
be immediately summoned and the management of the case left 
to him. In the milder bruises home remedies will usually 
answer. The part should be put at rest, elevated and com- 
pressed. Cold should be applied as soon after the injury as 
possible, except when the contusion is very severe or occurs in 
the debilitated or aged. A piece of ice or a towel wrung out 
of ice-water should be pressed upon the part. Pain when 
present is often relieved by applications of lead-water and 
laudanum. Later in the treatment of the ordinary bruise, but 
at the beginning in severe cases and when the patient is old or 
weakened, wet hot cloths should be applied. This is to be 
followed by daily massage and the use of a simple ointment. 



ACCIDENTS AND EMERGENCIES. 407 

Any complications that arise will have to be attended to by a 
physician. 

WOUNDS. 

A wound is an injury in which the skin has been broken. 
Wounds are divided in various ways: With regard to the 
nature of the injury we speak of cuts, stabs, punctures and torn 
and contused or bruised wounds; with reference to their 
manner of production we recognize gunshot wounds, machinery 
injuries, bites, etc. Wounds are clean or poisoned. 

The treatment of all wounds, no matter how produced, is 
essentially the same. The bleeding must first be stopped and 
reaction from shock brought about. All foreign bodies should 
be removed from the wound, which then is cleansed, closed and 
dressed, the part being subsequently kept at rest. Poisoned 
wounds require in addition special treatment. Further meas- 
ures are necessary if lockjaw is threatened, and when one has 
been bitten by a mad dog. Of course in every case a physician 
must be summoned. In many instances, however, one must 
act promptly without waiting for the doctor. Those eager to 
help should bear in mind the great principle of surgeons the 
world over, "Only do no harm." Unless a person knows the 
right thing to do, she had better proffer no assistance. In her 
ignorance she may do the patient much more harm than would 
result from leaving him alone until skilled help could be pro- 
cured. The directions in the following pages are not intended 
to make the reader an accident surgeon, but will teach her how 
to give first aid to the injured. 

ARREST OF HEMORRHAGE. 

In every wound some blood-vessels are cut open, allowing 
blood to escape. From the character of the bleeding one can 
often judge the nature of the vessel injured, upon which will 
depend the method employed for stopping the hemorrhage. In 
every case, however, the part should be elevated. 



408 ACCIDENTS AND EMERGENCIES. 

If blood trickles gently from the wound, it comes from 
the small capillaries. In such a case the bleeding may be 
arrested by pressing on the wound with a clean handkerchief 
or by pressing the sides of the wound together. The hand- 
kerchief may be dry or may be wet with cold water or ice-water, 
or it may be lightly wrung out of water as hot as the hand can 
bear. 

When a vein has been cut dark blood wells out in a steady 
stream. The method just described should first be tried; a 
dry folded handkerchief may be firmly bound on by means of a 
bandage or other handkerchief. As the veins usually lie near 
the surface, they may be shut off by the pressure of a medium 
tight bandage applied about the part. As the blood in the vein 
flows toward the heart, the bandage in such cases must be 
applied on the side of the wound farthest away from the heart. 
All constricting articles of dress, such as a garter, above the 
wound must be loosened or removed. The limb should always 
be elevated. 

In hemorrhage from an artery bright red blood spurts out 
with great force and in jerks, being pumped directly from the 
heart at each beat. Danger to life is great, as the person may 
bleed to death in a short time if the hemorrhage be not soon 
stopped. The limb should be raised and the clothes cut away. 
Pressure on the wound should first be tried. Pressure along 
the course of the chief artery supplying the part should then 
be made on the side of the wound nearer to the heart, inasmuch 
as the blood in an artery flows from the heart. The artery can 
usually be felt pulsating. Pressure can be made with the fingers 
or with a very tight bandage. The point where pressure must 
be applied depends upon the part wounded. 

When blood spurts from a wound in the hand or forearm, 
feel for the pulsations of the large artery of the arm, which lies 
along the inner side of the arm, pass a knotted handkerchief 
loosely around the arm so that the knot lies against the pul- 



ACCIDENTS AND EMERGENCIES. 



409 



sating artery, and tie the ends together. Next shove between 
the handkerchief and the arm a short stick (or a pencil, or cane, 
or brush handle, or door-key, or anything available) and twist 
this around until the bleeding stops, after which tie the end of 
the stick to the arm with another handkerchief to keep it from 
untwisting. This apparatus is known as the "Spanish wind- 
lass." It is merely a temporary expedient and should not be 
left on too long — certainly not more than an hour — without 




PRESSURE ON 
ARTERY OF ARM. 





SPANISH WINDLASS. 



PRESSURE ON ARTERY OF 
THIGH. 



being loosened, as it may produce mortification by shutting off 
all the blood to the part. An elastic bandage when at hand is 
to be preferred to the Spanish windlass. It must be bound 
several times about the limb at the same point, the clastic being 
stretched at each turn. The ends are then tied. If an India 
rubber bandage is nol at hand, a piece of rubber tubing, or a 
suspender brace, or an clastic belt, may be used instead 

In hemorrhage from the lower extremity pressure should 



410 ACCIDENTS AND EMERGENCIES. 

be made with both thumbs at the middle of the groin, in the 
front of the upper part of the thigh, as shown in the illustration. 
An elastic bandage or a Spanish windlass may be applied about 
the upper part of the thigh. 

REMOVAL OF FOREIGN BODIES FROM A WOUND. 

Splinters, bits of glass, portions of clothing, gun-wadding, 
grains of dirt, etc., may be present in a wound. Their removal 
ordinarily should be left to the physician, but in his absence may 
be undertaken by one less skilled. All foreign bodies that can 
be seen should be picked up with forceps or washed away by a 
stream of boiled water, or of a corrosive sublimate (bichloride 
of mercury) solution in the strength of i to 2000. 

CLEANSING THE WOUND. 

The area about the wound should first be scrubbed with 
castile soap, washed with water, scrubbed with alcohol and 
then with 1 to 1000 bichloride of mercury solution. The wound 
itself is then washed out by means of a stream of bichloride of 
mercury solution formed by squeezing out a clean boiled sponge 
or a mass of aseptic absorbent cotton which has been dipped in 
the solution and is held in the hand above the wound. When 
dirt has been ground into the wound it may be removed by 
pouring sweet oil on the wound, rubbing it into the tissues and 
then scrubbing the wound with soap and water. 

CLOSING AND DRESSING A WOUND. 

The closing and dressing of a wound is essentially the 
work of the surgeon. Simple and small cuts, however, may 
be closed by bringing the edges of the wound together and 
retaining them in this position by narrow strips of adhesive 
plaster placed across the wound. 

The best dressing is a piece of clean linen wrung out of 
1 to 1000 bichloride of mercury solution and laid on the wound 
until the arrival of the surgeon. If the patient is to be moved, 



ACCIDENTS AND EMERGENCIES. 411 

this dressing must be fastened in place by means of a bandage 
or handkerchief or scarf. 

KEEPING THE PART AT REST. 

When a wound is severe the patient is confined to bed. 
Later, and in milder cases, the injured part is supported in a 
bandage or sling, or in splints. 

POISONED WOUNDS. 

Various kinds of poisons may be present in a wound. 
Germs may cause the formation of pus and produce blood 
poisoning. Certain insects and reptiles have poisonous stings. 
Some injuries may lead to serious diseases, such as lockjaw and 
hydrophobia. 

Wounds Poisoned by Germs. — When germs enter a 
wound they cause it to putrefy, suppurate or slough. A physi- 
cian should always be in attendance, as there is real danger 
from blood poisoning. 

Stings of Bees, Wasps and Hornets.— When a sting has 
been left in the flesh it should be extracted. The part stung 
should then be treated by applications of arnica, ammonia- 
water, iodine, or solution of washing-soda, ichthyol, or lead- 
water and laudanum. If none of these be at hand the spot 'may 
be smeared with mud. Wet salt or a slice of onion are other 
home remedies. If the person is greatly prostrated, as some- 
times occurs, he should be given aromatic spirits of ammonia, 
or brandy, as in the treatment of shock. 

Snake-Bites. — The treatment of snake-bite consists in 
tying several constricting bands about the limb above the bite 
at different levels, cutting out the bitten area, sucking it strongly 
(rinsing the mouth out well afterwards), and cauterizing the 
wound with an acid or with heat. Ammonia-water or chloride 
of lime may be applied to the bite. Tn addition to these local 
measures whisky should be given internally in large doses. 



412 ACCIDENTS AND EMERGENCIES. 

Aromatic spirits of ammonia may also be administered. When 
the patient improves, the constricting bands are cautiously 
removed, the highest one first. After a time, if no symptoms 
reappear, the next is removed, and so on. Should symptoms 
occur, the band is reapplied. 

Bite of a Mad Dog. — Not every dog that bites is mad. 
If a dog that bites a person is suspected of being mad or rabid, 
it should not be killed, but should be kept in a safe place to see 
whether it sickens and dies. If it does not get sick or act 
queerly or die within a few days, it probably did not have rabies. 
If it dies, or if it should be killed, its head should be taken to 
the state health authorities for examination. They will be able 
to state whether the dog was mad or not. 

In every case of dog-bite a cross cut should be made in the 
flesh where the teeth penetrated and the wound should be 
cauterized with fuming nitric acid. 

If examination of the dog's head shows that the animal 
had rabies, or if the probabilities that it is rabid are great, the 
patient should be given the Pasteur treatment, which absolutely 
prevents the development of hydrophobia. This treatment, 
however, must begin within a week or ten days after the bite 
is inflicted. When rabies or hydrophobia has once developed 
there* is no cure. A bitten person may go for treatment to one 
of the Pasteur institutes, or, if living within twenty-four hours 
of New York City, he may be treated at home by his own 
physician, the virus for the Pasteur treatment being mailed to 
him by the New York Board of Health. The author has admin- 
istered the Pasteur treatment at their homes to several persons 
who were bitten by dogs which on examination proved to be 
mad. The patients were able to continue about their work, and 
none developed hydrophobia. 

The Prevention of Lockjaw. — The germ of tetanus, or 
lockjaw, is usually present in the earth. Consequently any 
wound that becomes contaminated with dirt, gunpowder, or 



ACCIDENTS AND EMERGENCIES. 413 

even with fresh garden earth, may give rise to lockjaw. The 
wounds that are most frequently followed by tetanus are those 
produced by blank cartridges, toy pistols and by fireworks in 
general, and those occurring when a rusty nail is run into the 
foot. Lockjaw is easily prevented, but when it once develops 
it is seldom cured. Prevention consists in immediately enlarg- 
ing the wound and cauterizing it, as previously described. In 
addition, a person who has been wounded by a toy pistol or a 
blank cartridge, or who suffers from any injury on the Fourth 
of July, or who runs a rusty nail in his foot, should be given 
an injection of antitetanic serum, which will absolutely prevent 
the occurrence of lockjaw, even if some of the tetanus germs 
should have entered the wound and not have been destroyed 
by the cauterization. 

SPRAINS. 

A sprain is a wrench of the joint caused by a sudden twist 
or pull. The ligaments of the joint are always stretched and 
frequently are torn; sometimes small pieces of bone are split off. 

In cases of sprain it is always necessary to call in a doctor. 
Until he arrives the joint must be kept at rest. It should be 
wrapped in absorbent cotton wet with iced water, which is held 
in place by means of a wet gauze bandage, the whole being put 
on an ice-bag. After several hours, if the physician has not 
yet appeared, the extremity affected should be bound in a splint 
(as described later under the Treatment of Fractures), and 
the joint should be encased in flannel, kept wet with lead-water 
and laudanum, iced water, arnica or a mixture of alcohol and 
water. The physician in charge will direct the further treat- 
ment. 

DISLOCATIONS. 

A dislocated joint is one that has been put out of place. 
It is always best to permit a physician to put a joint back into 
place. Ignorant handling may often increase the damage. The 



414 ACCIDENTS AND EMERGENCIES. 

only safe thing to do, therefore, when a dislocation occurs is to 
take the patient to a doctor as soon as possible. 

FRACTURES. 

A fractured or broken bone is recognized by the bending 
or shortening of the limb, unnatural movement, violent pain 
at the seat of the fracture and the grating of the ends of the 
bones against each other, felt when the limb is moved. 

No one but a physician or surgeon should attempt to set 
a broken bone. When, however, no surgeon is at hand, and 
when the patient has to be moved to a hospital or to a doctor, 
it is necessary to furnish some temporary support in order to 
keep the broken ends from moving. This is accomplished by 




BANDAGE AND SPLINT ON LEG. 



binding the limb throughout its extent to two stiff boards (or 
something similar) called splints, one being applied on each 
side. The best appliances are long thin boards, cotton and a 
linen bandage. These, however, cannot always be obtained, 
and one may be compelled to look around for material to use 
as splints and for means with which to fasten them on. In a 
town or near a house one endeavors to procure thin boards or 
cigar boxes, laths, shingles, broomsticks, yard measures, paste- 
board — often from books, hat-boxes, folded newspapers and 
magazines, etc.; felt — sometimes as old hats, boot-mats, 
brackets, cooking spoons, tongs, shovels and the like. If a 
pillow can be procured it should be placed under the limb, broad 
bandages being passed under it and tied over the limb so as to 
draw the sides of the pillow up firmly against it. It may be 



ACCIDENTS AND EMERGENCIES. 415 

possible to obtain from bystanders canes, umbrellas and 
parasols. When an accident happens out in the country or in 
a wood with no house in sight, one is forced to make use of 
branches, twigs, barks, reeds and stray bits of fencing and 
paling. If the injury occurs while horseback riding, leather 
and felt from the saddle and stirrups may be utilized. Firm 
pads can be made out of coat sleeves or shirt sleeves or stockings 
stuffed with grass, hay or straw. Before the bandage is applied 
the limb is padded to allow the splints to exert an even pressure. 
Wool, cotton-wool, flax and jute make excellent padding. 
Flannel, tow, hay and moss will also answer. 

In lieu of a bandage for fastening on the splints we may 
use pocket-handkerchiefs, neck-handkerchiefs, infant's binders, 
stockings, sheets, cord, garters, straps, such as stirrup-leather, 
or strips of clothing. 

Splints are used only when the fracture occurs in a limb. 
Fractures of other bones demand different treatment. 

Fracture of the Collar-Bone. — When the collar-bone is 
broken, the patient should lie flat on his back until the surgeon 
arrives. If he must be moved, however, the shoulders should 
be pulled back by means of a bandage or handkerchief brought 
or looped in front of the shoulders and tied in the back. 




DRESSING FOR FRACTURED RIB. 

Fracture of the Ribs.— When the ribs are fractured, the 



injured side of the chest is made immovable by binding it firml 



& 



with strips of adhesive plaster about two inches wide and 
reaching around one side of the chest, extending a little beyond 



416 ACCIDENTS AND EMERGENCIES. 

the median line, both front and back. They are applied parallel 
to the ribs, beginning at the lowest part of the chest and going 
upward, each strip overlapping the one below about half its 
width. Some force is used in compressing the chest as they are 
put on, the patient at the same time letting out his breath. 

THE ACTION OF POISONS. 

Internal Poisoning. — When a poison has been swallowed, 
a physician must be immediately summoned. But, without wait- 
ing for him, efforts must be made to get rid of the poison by 
producing vomiting, to protect the stomach and gullet from the 
corrosive action of irritant poisons by giving bland and oily 
liquids, to neutralize the poison by giving its antidote, and to 
stimulate the patient. 

Emetics are given to provoke vomiting, except when the 
poison is an acid, such as nitric, sulphuric and muriatic acids, 
or an alkali, such as ammonia, soda, potash and lye. Those 
most available usually are warm water, tepid salt water and 
warm mustard water (containing a tablespoonful of ground 
mustard to a pint of water). Vomiting may also be produced 
by tickling the back of the throat with the finger or a feather. 
The best drugs are ipecac, in doses of a teaspoonful of the 
powder or a tablespoonful or so of the syrup, and sulphate of 
zinc in ten-grain doses. 

Acids and alkalies act as antidotes to and neutralize one 
another. When an acid has been swallowed, alkalies dissolved 
in water are given. Those usually most easily procured are 
ammonia-water, soap, lime, soda, potash, whiting, chalk, tooth- 
powder, plaster, magnesia, whitewash, and wood ashes. If an 
alkali has been taken, acids, such as vinegar and lemon juice, 
are given. 

The bland and oily liquids that protect the lining of the 
stomach and gullet are any oil, white of egg or raw eggs, milk, 
gruel, flour and water, etc. 



ACCIDENTS AND EMERGENCIES. 



417 



Stimulation is brought about by administering tea, coffee, 
whisky, wine, and aromatic spirits of ammonia. 

The physician upon his arrival will direct the further 
treatment. 

BURNS WITH POISONS. 

The treatment of a burn with a poison depends upon its 
nature. After a burn by an acid the part should be washed 
freely with water, and then should be bathed with any alkali 
that may be at hand. When severe, it should be treated as a 
burn caused by heat. 

Burns with caustic alkalies should be treated with acids. 
The part should be washed with vinegar and water or dilute 
sulphuric acid; later oil should be applied, as in the case of 
ordinary burns. 




ARTIFICIAL RESPIRATION. 

DROWNING. 

A drowned person should be regarded as only apparently 
dead, and efforts at resuscitation should be commenced at once. 
The wet clothing, especially that confining the neck, chest or 
waist, must be removed. The mouth is opened and a finger 
wrapped in a pocket-handkerchief should be swept around the 
mouth and throat and introduced into the nose, in order to 
remove all mud or mucus or other possible accumulations. With 

37 



418 ACCEIPEHTS AND EMERGENCIES. 

the body lying on its face, one should stand at the head, and, 
clasping his hands under the stomach, raise the body while 
compressing the abdomen, until all the water has run out. The 
body should then be laid flat on its back, with the shoulders 
raised by means of a pad of some kind. Resting on one knee 
behind the head of the patient, the resuscitator grasps the arms 
and sweeps them away from the sides and up over the head, 
pulling on them rather strongly for a few seconds. This allows 
the lungs to fill with air. The arms are then brought down in 
front of the chest, with the elbow bent, and strong pressure is 
made for a second with them against the chest. These move- 
ments should be repeated about fifteen or sixteen times a minute 




ARTIFICIAL RESPIRATION. 

and should be persevered in until breathing is re-established or 
a physician has pronounced the patient dead. 

Natural respiration is promoted by holding snuff, smelling 
salts or ammonia-water near the nose, briskly rubbing or slap- 
ping the skin of the chest and face, dashing alternately hot and 
cold water on them, or beating the chest with a wet towel. A 
stimulant, such as whisky or brandy, should be given as soon 
as the patient can swallow. When breathing is carried on 
naturally, the efforts to produce artificial respiration are stopped 
and the patient is wrapped in warmed dry blankets and the 
limbs are rubbed under it. After this he is put into a warm 
bed with heat applied to all parts of the body by means of hot- 
water bottles or cans, or heated bricks. 



GLOSSARY 



GLOSSARY 



The glossary contains simple definitions of all technical terms and of' 
all other words that may not be easily understood. 

Abdomen. (Noun.) Belly;. the cavity of the body extending from the 
chest above to the pelvis below. (The word is sometimes used to 
designate the anterior wall of this belly cavity.) 

Abdominal. (Adj.) Pertaining to, or belonging to, the abdomen; situ- 
ated in or on the abdomen. 

Abdominal Binder. (Noun.) A bandage applied around the abdomen. 

Abnormal. (Adj.) Not conforming with the general rule of Nature. 

Absorb. (Verb.) To suck up. 

Absorbent. (Adj.) Capable of absorbing or sucking up. 

Absorption. (Noun.) The act or process of absorbing. 

Accentuated. (Verb.) Strongly marked. 

Accoucheur. (Noun.) One who attends women in childbirth. 

Adipose. (Adj.) Fatty; consisting of fat. 

Adolescence. (Noun.) Youth; the period between puberty and full 
development or maturity. (The word is used in this book to desig- 
nate the beginning of this period, about the age of fourteen in boys 
and of twelve in girls.) 

Aerated. (Verb.) i. Exposed to the action of fresh air. 
2. Impregnated with carbon dioxid. 

Alcoholic Drink. (Noun.) A beverage containing alcohol such as 
whisky, beer, etc. 

Algae. (Noun.) Plants growing in water, such as seaweeds. 

Alkaline. (Adj.) Having properties the opposite to those of an acid. 

Alkalinity. (Noun.) The quality or state of being alkaline. 

Alternate. (Verb.) To do or cause to be done in turn; to pass from 
one thing to another and back again, and so on indefinitely ; to inter- 
change. 

Alternate. (Adj.) Occurring by turns; every second. 

Amenorrhea. (Noun.) Absence of the menstrual flow when it should 
normally be present. 

Amniotic Fluid. (Noun.) The fluid that surrounds the embryo and 
fetus in the womb. (Same as liquor amnii.) 

Analyze. (Verb.) To ascertain the composition of. 

Anatomy. (Noun.) The study of the different tissues and organs of 
the body. 

431 



A22 GLOSSARY 

Anemia. (Noun.) A condition in which the iron in the blood is dimin- 
ished. 
Anesthetic. (Adj.) Pertaining to loss of sensation. 
Anesthetic. (Noun.) A substance that produces temporary insensibility 

to feeling or pain. 
Animal. (Adj.) Pertaining to animals. 
Antennae. (Noun.) The long " feelers " extending from the head of an 

insect. 
Antiseptic. (Adj.) Having power to destroy bacteria or germs and 

prevent their growth. 
Antiseptic. (Noun.) A chemical that destroys germs or prevents or 

restricts their growth. 
Anus. (Noun.) The outer opening of the rectum. 
Apparatus. (Noun.) A collection of instruments or of organs of the 

body all adapted for the accomplishment of a certain purpose. 
Application. (Noun.) i. The act of laying on. 

2. The thing laid on. 
Applicator. (Noun.) An instrument used in applying anything. 
Areola. (Noun.) The colored circular area about the nipple of a 

woman's breast. 
Asepsis. (Noun.) Absence of bacteria or germs. 
Asphyxiated. (Verb.) Suffocated ; deprived of air. 
Atmosphere. (Noun.) The measure of atmospheric pressure. (It cor- 
responds to the pressure of a vertical column of 30 inches of mercury 

and is taken as 15 pounds to the square inch.) 
Atomizer. (Noun.) An apparatus for converting a liquid into a fine 

spray. 
Attachment. (Noun.) That which binds or attaches one thing to an- 
other. 
Bacteria. (Noun.) Germs; a low order of plant life. (They are very 

minute, and multiply with great rapidity ; many forms of them cause 

disease.) 
Basket-bed. (Noun.) (See Bassinet.) 
Bassinet. (Noun.) A bed for a baby made out of a wicker basket. 

usually with a covering or hood over one end. 
Bath-apron. (Noun.) An apron made of two Turkish towels fastened 

together at the top. 
Batting. (Noun.) Cotton or wool arranged in sheets for quilting. 
Bed-board. (Noun.) A board placed across a bed. (Used for holding 

dishes or writing material.) 
Bed-cradle. (Noun.) A framework placed on the bed under the covers. 

(Employed to keep the bed-covers off the patient's body or limb.) 
Bed-pan. (Noun.) A flat shallow vessel for receiving the intestinal 

discharges of a bedridden patient. 
Bed-rest. (Noun.) An apparatus placed behind a patient to prop him 

up into a sitting position in bed. 



GLOSSARY 423 

Bedside-table. (Noun.) A table that extends over the bed when the 

stand is brought to the bedside. 
Bicuspids. (Noun.) The fourth and fifth teeth from the middle. 
Binder. (Noun.) A wide bandage worn about the abdomen. 
Birth-canal. (Noun.) The organs or parts through which the infant 

passes during its birth. (It includes the uterus, cervix, vagina and 

vulva.) 
Bladder. (Noun.) The organ that holds the urine after it leaves the 

kidneys and before it is voided externally. 
Blood-poisoning. (Noun.) The presence in the blood of germs or bac- 
teria that produce pus ; the presence in the blood of the poisons of 

such bacteria. 
Botany. (Noun.) The study of plants. 

Bouillon. (Noun.) A broth made by boiling meat in water. 
Breast. (Noun.) The organ or gland that in women secretes milk. 
Breast-pump. (Noun.) An instrument for drawing milk from the 

breast. 
Bright's Disease. (Noun.) Inflammation of the kidneys. 
Bronchial Tubes. (Noun.) The tubes through which the air passes in 

going from the windpipe into the lungs. 
Bronchitis. (Noun.) Inflammation of the bronchial tubes. 
Budding. (Noun.) The production of offspring by the formation of 

new cells as buds on an already existing cell. 
Butterin. (Noun.) An artificial substitute for butter made by churning 

margarin or oleomargarine — which is made from animal fat — with 

milk and water or with real butter. 
Buttocks, (Noun.) The fleshy parts below the hips ; the seat or bottom. 
Caked-breast. (Noun.) The distended breast of a nursing woman in 

which the milk has become hardened. 
Cancer. (Noun.) A malignant disease characterized by the formation 

of a tumor which finally ulcerates. 
Canine Tooth. (Noun.) The third tooth from the middle : eve tooth. 
Carriage. (Noun.) The manner of holding the body. 
Casein. (Noun.) The ingredient of milk that constitutes most of the 

curd and is the chief proteid. 
Catheter. (Noun.) An instrument that is inserted into the bladder 

through the natural passageway for the purpose of drawing off the 

urine. 
Catheterization. (Noun.) The drawing off of water from the bladder 

by means of a catheter. 
Catkin. (Noun.) The flowers of the willow, birch, etc. (Sometimes 

called " pussy-willow.") 
Causal. (Adj.) Being a cause. 
Cell. (Noun.) The smallest particle into which an animal or plant 

tissue can be divided. (Every living thing j s formed o\ cells.) 
Centrifugal Force. (Noun.) The force that causes anything that is 

swung around to fly off from the centre. 



424 GLOSSARY 

Cereals. (Noun.) The grain-plants whose seeds are used for food, 
such as wheat, rye, barley, etc. 

Cervix. (Noun.) The neck of the womb. 

Cessation. (Noun.) A stopping. 

Chafe. (Verb.) To make sore by rubbing. 

" Change of Life." (Noun.) The period of life at which the menses 
cease. 

Chap. (Verb.) To cause to split or crack. 

Chemically. (Adverb.) In a chemical sense; by a chemical process. 

Chemist. (Noun.) One whose business is to make chemical examina- 
tions. 

Chick. (Noun.) The embryo of a chicken. 

Child-bed Fever. (Noun.) Infection or blood-poisoning following 
child-birth ; puerperal sepsis. 

Child-birth. (Noun.) The act of giving birth to a child ; labor. 

Chloasmata. (Noun.) Brown spots appearing in the skin. 

Chlorosis. (Noun.) A form of anemia or poor blood ; the " Green sick- 
ness." 

Circulation. (Noun.) The flowing of the blood through the body. 

Climacteric. (Noun.) The period of life at which the menses or month- 
ly sickness cease. 

Clinical Thermometer. (Noun.) A thermometer used in taking a per- 
son's temperature. 

Coagulate. (Verb.) To clot ; to thicken ; to curdle. 

Cocoon. (Noun.) The silky case a caterpillar spins about itself before 
it is transformed into a butterfly. 

Cold Cream. (Noun.) An ointment containing oil of almond, sperm 
oil, white wax and rose-water. 

Colic. (Noun.) A severe griping pain in the abdomen. 

Colostrum. (Noun.) The milky fluid that can be expressed from the 
breasts of a pregnant woman and that flows for the first few days 
after the baby is born. 

Commercial. (Adj.) Prepared for the market and therefore not chem- 
ically pure. 

Communicable. (Adj.) Capable of being communicated. 

Complexion. (Noun.) The color of the skin, particularly that of the 
face. 

Complexion-brush. (Noun.) A brush used on the skin of the face. 

Composition. (Noun.) i. The manner in which a thing is made. 
2. The substance of which a thing is made. 

Compound. (Adj.) Composed of two or more ingredients; not simple. 

Compress. (Noun.) A folded cloth applied firmly to a part. Cooling 
Compress. A compress that is kept cold by being frequently placed 
upon ice or wrung out of ice water. Hot Compress. A compress 
that is kept hot by being wrung out of hot water at frequent inter- 
vals. (Cold) Stimulating Compress. A linen compress wrung out 
of cold water and covered with a dry flannel compress. 



GLOSSARY 425 

Conception. (Noun.) The fertilization of the female germ cell by the 
male germ cell. 

Condensed Milk. (Noun.) A white syrupy liquid made by evaporating 
most of the water from milk and then adding sugar. 

Condiments. (Noun.) Things used to give a relish to food. 

Conductor. (Noun.) A body that conducts or transmits (heat). 

Conduction. (Noun.) Transmission of heat from points of high tem- 
perature to points of low temperature. 

Confinement. (Noun.) Child-birth. 

Congestion. (Noun.) An abnormal accumulation of blood in an organ 
or part of the body. 

Conjugal. (Adj.) Pertaining to marriage. 

Consanguinity. (Noun.) Blood-relationship. 

Constipation. (Noun.) Infrequency and difficulty of bowel move- 
ments ; costiveness. 

Constituents. (Noun.) Parts, or necessary parts ; ingredients. 

Constriction. (Noun.) 1. A squeezing. 
2. The state of being squeezed. 

Consumption. (Noun.) A disease of the lungs due to a germ called 
the tubercle bacillus, and accompanied by wasting. 

Contagious. (Adj.) Communicable by means of contact with the per- 
son having the disease, or with anything (including air) that has 
been in contact with him ; catching. 

Contaminated. (Verb.) Rendered impure by contact. 

Contract. (Verb.) 1. To become smaller by being drawn together. 
2. To acquire by contagion. 

Convalescence. (Noun.) The gradual return to health after sickness. 

Conversion. (Noun.) A changing from one form into another. 

Convulsion. (Noun.) A violent and involuntary muscular contraction 
or series of contractions, often associated with unconsciousness. 

Corn. (Noun.) A hardening and thickening of the outer skin of the 
foot caused by friction or undue pressure, usually from the shoe. 

Corpulence. (Noun.) Fatness. 

Cosmetic. (Noun.) A preparation for improving the complexion. 

Creeping-pen. (Noun.) A low wooden fence that is placed around 
the baby to confine it to a certain portion of the room. 

Croup. (Noun.) A disease of the lower portion of the throat and of 
the windpipe, associated with difficulty in breathing and with a pe- 
culiar brassy cough. (The word is commonly but incorrectly used 
by uninformed persons in describing any acute harsh cough). Mem- 
branous croup is diphtheria attacking the lower portion of the throat 
and the windpipe. 

Crow's-feet. (Noun.) Wrinkles appearing under and around the outer 
corner of the eye. 

Curdle. (Verb.) To thicken, or cause to thicken and form curds. 

Curds. (Noun.) The part of milk that has thickened or curdled. 

Cuticle. (Noun.) The outermost layer of the skin: scarf-skin. 



426 GLOSSARY 

Dandruff. (Noun.) Small scales or dust coming from the scarf-skin, 

or outer skin, of the scalp. 
Deaf Mutism. (Noun.) The condition of being both deaf and dumb. 
Debilitated. (Verb.) Weakened. 
Decoction. (Noun.) i. The act of boiling. 

2. The water in which a substance has been boiled. 
Deformity. (Noun.) Unnatural shape. 
Degeneracy. (Noun.) The tendency to deteriorate and go from better 

to worse. 
Degenerate. (Adj.) Tending to become worse. 
Deleterious. (Adj.) Injurious. 
Delivery. (Noun.) The birth of the child. 

Dementia. (Noun.) A form of insanity marked by progressive impair- 
ment of the mental faculties. 
Density. (Noun.) Compactness. 

Dental Floss. (Noun.) A silky substance used for cleansing the teeth. 
Dentition. (Noun.) i. The process of cutting the teeth, or teething. 

2. The period during which the teeth are cut. 
Deterioration. (Noun.) Lowering of the character or constitution. 
Detrimental. (Adj.) Hurtful. 

Development. (Noun.) A gradual growth through progressive changes. 
Devote. (Verb.) To set apart. 
Diagnosis. (Noun.) Recognition of a disease. 
Diernal. (Adj.) Pertaining to the day. 
Digestible. (Adj.) Easy of digestion. 
Digestion. (Noun.) The process the food undergoes in the body before 

it can enter the blood. 
Dilute. (Verb.) To weaken by adding water. 
1 Dip. (Noun.) A brief plunge. 
Discharge. (Noun.) A flowing out. 
Disinfection. (Noun.) The rendering free from germs. 
Disseminate. (Verb.) To scatter; to spread by scattering. 
Distinction. (Noun.) The mark of difference. 
Door Jamb. (Noun.) The side of a door-way. 
Douche. (Noun.) A jet of water striking the body, or entering one 

of its cavities. 
Douche-pan. (Noun.) A pan used to catch the water in douching the 

vagina. 
" Dropping." (Noun.) The flattening of the abdominal wall that occurs 

when the womb containing the unborn child drops from the abdomen 
into the pelvis. 
Dyspeptic. (Adj.) Suffering from indigestion. 

Ebullition. (Noun.) A bubbling up (used figuratively) ; a sudden burst. 
Economic. (Adj.) i. Domestic; 2. relating to the means of living; 

3. saving. 
Effervescent. (Adj.) Bubbling with a hissing sound. 
Elements. (Noun.) Parts. 



GLOSSARY 427 

Elevate. (Verb.) To raise. 

Embryo. (Noun.) The unborn animal in the earlier stages of develop- 
ment. 
Emulsion. (Noun.) A mixture of an oily substance with a liquid. 
Enema. (Noun.) An injection into the rectum; a clyster. 
Entente. (Noun.) Meaning. 

Environment. (Noun.) Surrounding things and conditions. 
Epidermis. (Noun.) The outer layer of skin; scarf-skin. 
Epilepsy. (Noun.) A disease characterized by sudden loss of conscious- 
ness and by convulsions, known as fits. 
Epoch. (Noun.) A definite period of time. 
Eradicate. (Verb.) To remove utterly. 
Eruption. (Noun.) A rash or breaking out. 
Evacuate. (Verb.) To empty. 
Evaporation. (Noun.) Conversion into vapor. 
Excretion. (Noun.) 1. A throwing out or discharge of the waste 

products of an organ or of the body. 

2. The substance thus thrown out or discharged. 
Exhale. (Verb.) To breathe out. 
Expiration. (Noun.) Breathing out. 
Expiratory Act. (Noun.) The act of breathing out. 
Fad. ( Noun. ) A fancy, whim or hobby. 
Fallopian Tube. (Noun.) The tube from the ovary to the womb. 

through which the ovum passes. 
Fat-free Milk. (Noun.) Milk from which all the fat has been removed. 
Feces. (Noun.) The matter expelled from the rectum; dung. 
Female. (Adj.) Pertaining to those animals or plants that are capable 

of producing offspring. 
Fencing. (Noun.) An exercise or contest with blunt swords, known 

as foils. 
Fertilization. (Noun.) The meeting of the male germ-cell and the 

female germ-cell, by which the latter is made capable of developing 

into a new individual. 
Fertilize. (Verb.) By the addition of the male germ-cell to render the 

female germ-cell capable of developing into a new individual. 
Fetus. (Noun.) The unborn animal in the later stages of development. 
Fibroid. (Noun.) A muscle-tumor of the womb. 
Fissures. (Noun.) Cracks. 

Flatulence. (Noun.) The presence of wind in the stomach or intestines. 
Flocculent. (Adj.) Fleecy; flaky. 
Floss. (Noun.) A silky substance growing on certain plants, such as 

corn and milkweed. 
Fomentation. (Noun.) Flannels or other cloths wrung out of hot 

water and placed on the body as a means o\ applying moist heat 
Fontanelle. (Noun.) A spot on the top of the baby's head where the 

bone is absent. 



428 GLOSSARY 

Formula. (Noun.) A list of the names and quantities of the ingre- 
dients of a mixture. 
Foster-child. (Noun.) A child nursed by one not its mother. 
Fountain-syringe. (Noun.) A syringe consisting of a rubber bag 

connected with a rubber tube. 
Function. (Noun.) The use, work or mode of action of an organ. 
Functionate. (Verb.) To act. 
Genealogical. (Adj.) Pertaining to the descent of a person or family 

from an ancestor. 
Generative. (Adj.) Pertaining to the process of begetting offspring. 
Genital. (Adj.) Pertaining to the organs concerned in the process of 

reproduction or begetting offspring. 
Germ. (Noun.) A microbe; a minute form of plant life, frequently 

causing disease. 
Gestation. (Noun.) Pregnancy; the condition of carrying a developing 

child in the womb. 
Gesture. (Noun.) An expressive movement of the body or limbs. 
Gland. (Noun.) An organ of the body that secretes substances useful 

to the body or that throws out waste matters. 
Golf. (Noun.) A game in which a small ball is driven by means of 

sticks from one hole to another. 
Gradations. (Noun.) Progress by steps. 
Gravity-cream. (Noun.) The cream that rises to the top of a vessel 

in which milk has been standing. 
Grimace. (Noun.) A distortion of the face. 
Gynecology. (Noun.) The study and treatment of diseases peculiar to 

women. 
Hemorrhage. (Noun.) Bleeding. 
Hemorrhoids. (Noun.) Enlarged and thickened veins about the anus; 

piles. 
Heredity. (Noun.) The transmission of form and traits from parent to 

offspring. 
Hot- Water Bag. (Noun.) A rubber bag which is filled with hot water 

and used in applying dry heat. 
Hydra. (Noun.) A small water plant. 
Hydrotherapy. (Noun.) Treatment by means of water. 
Hygiene. (Noun.) The science and art of preserving the health. 
Hymen. (Noun.) The membrane stretched across the external opening 

of the vagina and partly closing it. 
Hypochondriac. (Noun.) A person suffering from hypochondriasis. 
Hypochondriasis. (Noun.) A diseased condition in which the person is 

always anxious about his health and imagines that he has various 

ailments. 
Ice-bag. (Noun.) A rubber bag, which is filled with ice and used for 

applying dry cold. 
Idiocy. (Noun.) One without mental understanding from birth. 
Illegitimate. (Adj.) Contrary to law or custom; born out of wedlock. 



GLOSSARY 429 

Imbecile. (Noun.) One who is mentally feeble. 

Immerse. (Verb.) To dip. 

Impermeable. (Noun.) Not permitting the passage of a fluid through 

its substance. 
Impervious. (Adj.) Not to be passed through. 
Impoverished. (Verb.) Made poor. 
Impregnated. (Verb.) Made pregnant or fertilized by the addition ot 

the male germ-cell to the female germ-cell. 
Incisors. (Noun.) The four front teeth in each jaw. 
Incubator, (Noun.) An apparatus for preserving the life of a prema- 
turely born infant. 
Infected. (Verb.) Tainted; brought into contact with disease or disease 

germs. 
Infection. (Noun.) The communication of disease or of disease germs. 
Inferior. (Adj.) Lower. 

Ingredients. (Noun.) Substances of which a mixture is composed. 
Inherit. (Verb.) To receive from a parent or other ancestor. 
Iniquity. (Noun.) Wrong; wickedness; gross injustice. 
Injection. (Noun.) 1. The act of throwing or forcing in. 

2. That which is thrown or forced in. 
Injunction. (Noun.) Command. 
Insomnia. (Noun.) Sleeplessness. 
Inspiration. (Noun.) The act of breathing in. 
Intensity. (Noun.) Degree. 
Intermission. (Noun.) Temporary cessation. 
Intermittent. (Adj.) Ceasing at intervals. 
Interval. (Noun.) A space or period between. 
Introspective. (Adj.) Examining and studying oneself. 
Inverted. (Verb.) Turned upside down. 
Involution. (Noun.) The gradual return of the womb to its normal 

size and condition after labor. 
Irremedial. (Adj.) Beyond remedy ; incurable. 
Irreparable. (Adj.) Incapable of being repaired. 
Irrevocable. (Adj.) Not to be recalled. 
Irritable. (Adj.) Easily stimulated. 
Irritation. (Noun.) The act of exciting. 
Isolation. (Noun.) The complete separation from other persons of one 

sick with a contagious disease. 
Kindergarten. (Noun.) A school for very young children, where the 

instruction is imparted by the use of objects, games and songs. 
Kumyss. (Noun.) Fermented milk. 
Labia. (Noun.) The folds on the sides of the vulva. 
Labor. (Noun.) Childbirth. 
Laboratory. (Noun.) Chemical workshop. 
Laceration. (Noun.) A tear. 
Lactation. (Noun.) The secretion of milk. 
Lancinating. (Adj.) Sharp and shooting. 



430 GLOSSARY 

Larynx. (Noun.) The part of the throat where the voice is produced. 
Latent. (Adj.) Hidden. 

Laxative. (Noun.) A medicine that moves the bowels gently. 
Leucorrhea. (Noun.) A whitish or mucous discharge from the vagina. 
Ligament. (Noun.) A band of tissue binding one part to another. 
Lightening. (Noun.) The flattening of the abdomen caused by the 

dropping of the womb into the pelvis during the last weeks of preg- 
nancy. 
Lime-water. (Noun.) A solution of lime. 

Liquor Amnii. (Noun.) The water surrounding the child in the womb. 
Lochia. (Noun.) The discharge from the womb in a woman after 

childbirth. 
Loins. (Noun.) The lower part of the back and the region of the 

hips. 
Lubricant. (Noun.) An oily or greasy material used to make things 

smooth or slippery. 
Lunar. (Adj.) Pertaining to the moon. 
Lying-in. (Adj.) Pertaining to childbirth. 
Mackintosh. (Noun.) i. Cloth rendered waterproof by a solution of 

India rubber. 

2. A garment made out of such cloth. 
Male. (Adj.) Pertaining to those animals and plants which add that 

element to a female germ-cell by which the latter is made capable of 

developing into a new individual. 
Mammals. (Noun.) Animals that suckle their young. 
Mammary Binder. (Noun.) A bandage or support for the breasts. 
Mammary Glands. (Noun.) The breasts. 

Manipulation. (Noun.) The act of handling or working with the hands. 
Margarin. (Noun.) A fatty substance extracted from lard or oil. 
Massage. (Noun.) A rubbing and kneading of the muscles. 
Mastication. (Noun.) The act of chewing. 
Matrimony. (Noun.) The state of marriage. 
Mature. (Adj.) Fully developed. 
Maturity. (Noun.) Full development. 
Membrane. (Noun.) A thin lining tissue. 

Membranous Croup. (Noun.) Diphtheria of the larynx or lower throat. 
Meconium. (Noun.) A black substance discharged from the bowels 

of a new-born infant. 
Meningitis. (Noun.) An inflammation of the membranes covering the 

brain or spinal cord. 
Menopause. (Noun.) The final cessation of the menses or monthly 

courses. 
Menstrual. (Adj.) Pertaining to the monthly sickness. 
Menstruation. (Noun.) The monthly flow of blood in a woman. 
Mental. (Adj.) Pertaining to the mind. 

Microbe. (Noun.) A minute living thing or germ, often causing disease. 
Microscope. (Noun.) An instrument for magnifying. 



GLOSSARY 43i 

Midwife. (Noun.) A woman who makes a practice of assisting women 

in childbirth. 
Midwifery. (Noun.) The practice of assisting women at childbirth. 
Milk-cake. (Noun.) The caking of milk in a distended breast. 
Milk Laboratory. (Noun.) A place where milk is analyzed and where 

babies' bottles are filled according to prescription. 
Milk-sugar. (Noun.) A sugar made by the evaporation of the whey of 

milk. 
Milk-teeth. (Noun.) The first set of teeth. 
Minimum. (Noun.) The smallest amount or degree. 
Mitigated. (Verb.) Made lighter. 
Mixed Feeding. (Noun.) The feeding of a baby by both the breast 

and the bottle. 
Moccasin. (Noun.) A shoe made of soft leather with a stiff sole. 
Modify. (Verb.) To change. 
Molars. (Noun.) The back teeth. 

Monogamy. (Noun.) The condition of being married to only one per- 
son at one time. 
Monopolize. (Verb.) To obtain or use the whole of. 
Monotony. (Noun.) Sameness. 

Morbid. (Adj.) 1. Diseased; 2. depressed in spirits. 
Morning Sickness. (Noun.) Nausea or sickness at the stomach felt 

by a pregnant woman in the morning. 
Moroseness. (Noun.) Sullenness ; sourness of temper. 
Mortality. (Noun.) Frequency of death. 
Mucous. (Adj.) Pertaining to, or consisting of, mucus. 
Mucus. (Noun.) A slimy fluid secreted by the mucous membrane of 

animals. 
Municipal. (Adj.) Pertaining to the town government. 
Nausea. (Noun.) Sickness at the stomach. 
Navel. (Noun.) The mark or knob in the centre of the abdomen; 

belly-button. 
Neuralgia. (Noun.) Pain along the course of a nerve. 
Neurotic. (Adj.) Nervous. 
Nipple. (Noun.) 1. The teat or portion of the breast sucked by the 

baby. 

2. A rounded hollow piece of rubber attached to the mouth of a 

nursing bottle. 
Nits. (Noun.) The eggs of the louse. 
Nocturnal. (Adj.) Pertaining to the night. 
Non-conductor. (Noun.) A substance that does not conduct heat or 

electricity. 
Normal. (Adj.) According to the rule of Nature. 
Nozzle. (Noun.) The tip or end of a syringe. 
Nutritive. (Adj.) Nourishing. 
Obese. (Adj.) Fat. 



432 GLOSSARY 

Obstetrics. (Noun.) The management of childbirth and the care of a 
woman during, after, and before childbirth. 

Obtund. (Verb.) To dull. 

Occlusive, (Adj.) Closing; shutting up. 

Oculist. (Noun.) A physician skilled in the treatment of the eyes. 

Offspring. (Noun.) Descendants. 

Opaque. (Adj.) Not transparent. 

Operative. (Noun.) A workman. 

Optician. (Noun.) One who makes or sells glasses for the eyes. 

Orange-stick. (Noun.) A small sharpened stick of orange- wood used 
in cleansing the nails. 

Organism. (Noun.) A member of the animal or vegetable kingdom. 

Os. (Noun.) Mouth or opening of the neck of the womb. 

Ovary. (Noun.) That part of a female animal or plant containing the 
female germ-cells. 

Oviduct. (Noun.) The tube through which the ovum or female germ- 
cell passes on its way from the ovary to the womb. 

Ovulation. (Noun.) The discharge of an ovum or female germ-cell 
from the ovary into the v/omb. 

Ovule, (Noun.) A young, undeveloped seed. 

Ovum. (Noun.) The tgg or female germ-cell formed in the ovary of 
an animal. 

Palatable. (Adj.) Agreeable to the taste. 

Parallel. (Adj.) Having the same direction. 

Parasites. (Noun.) Insects living on animals, such as lice. 

Paroxsym. (Noun.) Spasm. 

Participation. (Noun.) The act of taking part. 

Parturition. (Noun.) Childbirth. 

Passion. (Noun.) Intense emotion. 

Pasteurization. (Noun.) The heating to 140 F. in order to destroy 
dangerous germs. 

Pelvis. (Noun.) The bony basin holding the womb, bladder and rec- 
tum, etc. 

Pendulous. (Adj.) Hanging. 

Penetrate. (Verb.) To pierce into or through. 

Perambulator. (Noun.) Baby-coach. 

Percentage. (Noun.) Rate per hundred. 

Periodic. (Adj.) Occurring at regular periods. 

Peritonitis. (Noun.) Inflammation of the outer coat of the intestines. 

Perpetuation. (Noun.) Continuation. 

Phenomenal. (Adj.) Remarkable. 

Phenomenon. (Noun.) A thing that is observed. 

Physical. (Adj.) Bodily. 

Physiology. (Noun.) The science that treats of the work of living 
things — what they do. 

Pistil. (Noun.) The female or seed-bearing organ of a flower. 



GLOSSARY 433 

Piston. (Noun.) The movable piece that fits into the barrel of a 
syringe. 

Placenta. (Noun.) After-birth. 

Placid. (Adj.) Calm. 

Pneumonia. (Noun.) Inflammation of the lungs. 

Poise. (Noun.) The position in which all the parts are balanced. 

Pollen. (Noun.) The male part of the flower, appearing as a fine yel- 
lowish dust. 

Polyp. (Noun.) A tumor composed of mucus. 

PommeL (Noun.) The part of a side saddle fitting under or over the 
knee. 

Pores. (Noun.) The openings of the sweat glands in the skin. 

Proportionately. (Adv.) According to a certain rate. 

Poultice. (Noun.) A hot soft mass used for applying moist heat. 

Precept. (Noun.) Instruction. 

Predisposition. (Noun.) Tendency or inclination. 

Pregnancy. (Noun.) The state of being with child. 

Pregnant. (Adj.) Being with child; "in the family way." 

Prematurely. (Adv.) Before the proper time. 

Primitive. (Adj.) Earliest. 

Principle. (Noun.) A well-known truth. 

Promiscuity. (Noun.) The absence of the institution of marriage in a 
people. 

Proteid. (Noun.) The substance that constitutes the nourishing part 
of meat and forms the cheesy part of milk. 

Provisional. (Adj.) Temporary. 

Pruritis. (Noun.) Itching. 

Puberty. (Noun.) The period of life at which a human being becomes 
capable of producing offspring. 

Pubic. (Adj.) Pertaining to the front of the pelvis. 

Puerperal Sepsis or Puerperal Fever. (Noun.) Blood-poisoning after 
childbirth. 

Puerperium. (Noun.) The period following childbirth. 

Pulse-rate. (Noun.) The number of pulse beats in a minute. 

Purgative. (Noun.) A medicine that cleans out the bowels. 

Pus-tube. (Noun.) An abscess of the fallopian tube. 

Putrid. (Adj.) Decayed. 

Quarantine. (Noun.) The guarding of a dwelling \ n which a con- 
tagious disease exists, so that no one can go in or out. 

Quickening. (Noun.) The movements of the child in the womb as felt 
by the mother. 

Radical. (Adj.) Going to the root. 

Ratio. (Noun.) Proportion or relation of conditions. 

Reaction. (Noun.) The return to warmth after the application of cold. 

Receptacle. (Noun.) That which receives or holds anything 

Recline. (Verb.) To lie. 

Rectum. (Noun.) The lower end of the intestines. 
38 



434 GLOSSARY 

Reflect. (Verb.) To throw off. 

Regurgitating. (Noun.) The vomiting of infants. 

Relax. (Verb.) To make less rigid. 

Remittent. (Adj.) Disappearing temporarily. 

Reproduction. (Xoun.) The formation of new animals or plants by 

and from those already existing. 
Respiration-rate. (Xoun.) The number of times a minute a person 

breathes. 
Respiratory. (Adj.) Pertaining to the breathing. 
Restrict. (Verb.) To limit. 
Resuscitate. (Verb.) To revive. 
Retard. (Verb.) To delay; to hinder. 

Reversible. (Adj.) Capable of being turned in the opposite direction. 
Rickets. (Xoun.) A disease of children in which the bones fail to 

become hard. 
Rose. (Xoun.) A perforated nozzle that distributes water in a spray 

or shower. 
Rubella. (Noun.) German-measles. 
Rash. (Xoun.) A breaking out or eruption. 
Rural. (Adj.) Pertaining to the country. 
Saliva. (Xoun.) The secretion always present in the mouth. 
Sallow. (Adj.) Of a brownish yellow color. 
Saturated-solution. (Xoun.) A solution of a substance in which no 

more of that substance can be dissolved. 
Savory. (Adj.) Pleasing to the taste or smell. 
Scrofulous. (Adj.) Tuberculous; subject to enlargement of the glands 

of the neck, due to the germs causing consumption. 
Scurvy. (Noun.) A disease caused by the lack of wholesome diet. 
Secluded. (Verb.) Separated from others. 
Secrete- (Verb. I To produce by the action of a gland. 
Secretion. (Xoun.) i. The production of a substance bv the action 

of a gland. 

2. The substance produced by the action of a gland. 
Sedentary. (Adj.) Sitting. 

Semi-recumbent. (Adj.) Partially lying; leaning. 
Sepsis. (Xoun.) Poisoning by germs. 

Sexual. (Adj.) Pertaining to the production of offspring. 
Show. (Xoun.) The blood-stained plug of mucus that is expelled dur- 
ing the first stage of labor. 
Sitz-bath. (Xoun.) Hip-bath. 
Snarls. (Xoun.) Tangles. 

Soft Water. | Noun.) Water containing little or no lime. 
Sparingly. (Adv.) With moderation. 
Spasmodic. (Adj.) Occurring in spasms. 
Species. (Xoun.) A name given to any collection or family of animals 

or plants which resemble each other, but which differ from all other 

animals or plants. 



GLOSSARY 435 

Spermatozoon. (Noun.) The male germ-cell. 

Sphery. (Adj.) Pertaining to the heavens. 

Spray. (Verb.) To sprinkle with fine drops. 

Sputum. (Noun.) Spittle. 

Stamen. (Noun.) The male part of a flower, containing the pollen. 

Starch-water. (Noun.) Water in which starch has been dissolved. 

Stays. (Noun.) Corset. 

Sterilize. (Verb.) To render free from living germs. 

Stigma. (Noun.) The upper portion of the pistil or female part of the 
flower, which receives the pollen. 

Stimulate. (Verb.) To excite to action. 

Stoical. (Adj.) Taking no notice of pleasure or pain. 

Stockingette. (Noun.) An elastic knitted material. 

Stomach-teeth. (Noun.) The two milk teeth on either side of the four 
lower front teeth. 

Striae. (Noun.) Lines or furrows. 

Structure. (Noun.) Arrangement of the parts. 

Stunting. (Verb.) Checking the growth of. 

Stupe. (Noun.) A cloth wrung out of hot water and used for applying 

moist heat. 
Style. (Noun.) The long portion of the pistil or female part of the 

flower. 
Subdivide. (Verb.) To divide again. 
Subject. (Noun.) A person under treatment. 
Submerged. (Verb.) Put under water. 
Subordinate. (Adj.) Of less importance. 
Substitute. (Verb.) To put in the place of another. 
Suckle. (Verb.) To nurse. 
Sugar of Milk. (Noun.) See " Milk-sugar." 
Suppression. (Noun.) The stoppage of a discharge. 
Surf-bathing. (Noun.) Bathing in the ocean. 
Surgical Cleanliness. (Noun.) Freedom from germs. 
Suspended. (Verb.) Hung. 

Sweat-bath,. (Noun.) A procedure to produce sweating. 
Symmetrical. ( Ad j . ) Well-proportioned. 
Symptom. (Noun.) Sign of disease. 
Synonymous. (Adj.) Expressing the same idea. 
Syringe. (Noun.) An instrument used to inject liquids. 
.System. (Noun.) A collection of tissues or organs of the bodv doim* 

the same work. 
Tadpole. (Noun.) That stage in the development of the frog from 

the time it leaves the egg until it loses its gills and tail 
Taint. (Noun.) Blemish. 
Teething. (Noun.) The cutting of the teeth. 
Temperate. (Adj.) Moderate. 
Temperature. (Noun.) The degree of heat. 
Tendency. (Noun.) Inclination. 



43^ GLOSSARY 

Tether-Tennis. (Noun.) A game played with a ball fastened by a 
string to the top of a tall post, the object being to wind the string 
around the pole. 

Texture. (Noun.) The arrangement of threads in a cloth. 

Tissue. (Noun.) A collection of cells of the body doing the same work. 

Tocology (Also spelt tokology). (Noun.) The management of child- 
birth. 

Toilet. (Noun.) The process of dressing. 

Transient. (Adj.) Temporary. 

Transmission. (Noun.) The handing down. 

Tuber. (Noun.) The thickened portion of an underground stem of a 
plant, such as a potato. 

Tuberculosis. (Noun.) A disease caused by the tubercle bacillus or 
germ producing consumption. 

Tumor. (Noun.) An abnormal enlargement or swelling of a part. 

Umbilical Cord. (Noun.) The cord extending from the placenta or 
afterbirth to an infant's navel and containing the blood-vessels 
through which the child is nourished while in the womb. 

Umbilicus. (Noun.) A knob in the center of the abdomen ; navel ; belly- 
button. 

Unfertilized. (Verb.) Not rendered capable of developing into a new 
individual. 

Unhygienic. (Adj.) Contrary to the laws of health. 

Urine. (Noun.) The liquid that comes from the kidneys through the 
bladder. 

UrinaL (Noun.) A vessel for holding urine. 

Urination. (Noun.) The act of passing urine or water. 

Uterus. (Noun.) Womb. 

Vaccinate. (Verb.) To inoculate with vaccine or the virus of cow-pox 
in order to prevent the occurrence of small-pox. 

Vagina. (Noun.) The tube extending from the womb to the outer 
parts. 

Varicose- Veins. (Noun.) Swollen, thickened veins. 

Vegetable. (Adj.) Pertaining to plants. 

Ventilation. (Noun.) The process of replacing foul air with pure air. 

Vernix Caseosa. (Noun.) A fatty matter covering the skin of a new 
born infant. 

Vicarious. (Adj.) Taking the place of another. 

Vitality. (Noun.) Vigor. 

Vitiate. (Verb.) To spoil ; to injure the quality of. 

Vivacity. (Noun.) Liveliness of manner. 

Voiding. (Verb.) Emptying out. 

Vomiting. (Verb.) The throwing-up of matter from the stomach. 

Vulva. (Noun.) The external private parts of a female. 

Waters. (Noun.) The liquid that surrounds a child as it lies in the 
womb. 



GLOSSARY 437 

Weaning. (Verb.) Removing a nursing infant permanently from its 
mother's breast. 

Wet-Nurse. (Noun.) A woman employed to suckle the infant of an- 
other. 

Whey. (Noun.) That part of milk which remains fluid after the curds 
have formed. 

Womb. (Noun.) The female organ in which a child lies while de- 
veloping. 

Veast. (Noun.) A minute plant consisting of a number of cells joined 
together employed in raising bread and in fermenting beer. 



INDEX 



INDEX 



ABDOMEN 

appearance of, in sick child, 307 
during pregnancy, 157, 158 

alterations in shape of, 158 

bandage for support of, 163 

change in appearance of, 158 

changes in, 157, 158 

increase in size of, 158 
pain in, relief of, 352 

cold applications for, 352 

hot cloths for, 352 

hot poultice for, 352 

hot water-bag for, 352 

ice-bag for, 352 

vaginal douche for, 352 
pendulous, abdominal elastic bandage 
for, 352 

ABORTION 
a cause of women's disease, 385 
after-treatment of, 371, 372 
appearance of ovum in, 369 
artificially produced, 385 
causes of, 367, 368 
character of hemorrhage in, 368 
course of, 367 
criminal, 369 
danger of, 369 
expulsion of ovum in, 368 
inevitable treatment of, 371 
invalidism caused by, 371 
pain in, 368 
prevention of, 369 
self-induced, 369 

sickness caused by neglect after. 371 
signs of, 368, 369 
symptoms of, 368, 369 
threatened, to avert, 370 
treatment of, 370, 371 

ABSENCE OF MENSTRUATION 
(See Menstruation, absence of.) 

ABSORBENT PAD 
for confinement, 176 
how to make, 176 



ACCOUCHER 

engagement of, 180 

midwife not desirable as, 181 

physician best, 181 

ADOLESCENCE 
(See Puberty.) 
age of, in girls, 100 
mental changes at, 102 
mother's duty at time of, 103 
religious changes at, 103 

ADVERTISING PHYSICIANS 

avoidance of, 375 
AFTERBIRTH 

(See Placenta.) 

formation of, 153 

AFTERPAINS, 194 
AIRING 

infant's first, 283 

ALBUMEN-WATER 
how prepared, 342 
in intestinal disorder of infants, 341 

ALCOHOL 

habitual use of, a cause of sterility, 374 
AMNIOTIC FLUID 

(See Liquor amnii.) 
AMENORRHEA 

(See Menstruation, absence of, sup- 
pression of.) 

AMUSEMENTS 

for the baby, 286 

ANATOMY 
of female reproductive organs. 96 
of pelvic organs. 06 

ANEMIA 

absence of menstruation .in. 362 
painful menstruation in, 365 



441 



442 



INDEX 



ANESTHETIC 
administration of, during labor, 203 

ASEPSIS 

as a preventive of puerperal sepsis, 

200 
definition of, 200 

ASEPTIC 

how to keep a thing aseptic, 201 
how to make a thing aseptic, 201 
importance of aseptic articles during 
labor, 201 

ASPHYXIATION 

treatment of new-born infant in, 206, 
208 

BABY 

(See Infant.) 

age at which it notices, stands, walks, 

talks, etc., 227 
amusing, 286 
basket for, 178 
bassinet for, 278, 279 
bathing, 262, 265 

after highly contagious disease, 330 
bed for, 278 
bibs for, 271 
binder for, 268 

bowel movements of, 226, 310. 311 
calomel may be given to, 343 
cap for, 269 

castor-oil may be given to, 343 
chalk mixture for diarrhea of, 343 
cleansing bath of, 315 
cloak for, 269 
clothes for, 179 
clothing for, 268 
coach for, 285 
coat for, 269 

common affections of, 323 
conformity of chest of, 307 
cough of, 306 
cradle for, 279 
creeping apron for, 271 
crib for, 279, 280 
cry of, character of, 305 

significance of different kinds of, 
305, 306 
danger of giving laudanum to, 343 

opium to, 343 

paregoric to, 343 

soothing syrup to, 343 



diapers for, 268 

-supporters for, 270 
diarrhea of, 340, 341 
drawers for, 270 
dress for, 269 
drying, 264, 265 
enema, administering to, 321 

for colic of, 348 
exercising, 283, 286 
feeding of, 228 
feeding unconscious, 317 
foot-gear for, 271 
hours for sleeping, 276, 277 
how to carry, 284 
how to hold, during paroxysm in 

whooping-cough, 336 
how to put to sleep, 275 
how to tell when ill, 305 
intestinal disorders of, 340 

care of, in, 341 

clothing in, 342 

cool bath in, 343 

diet in, 341 

external remedies in, 342 

hot bath in, 343 

medicine in, 343 

pain in, 341 

rest in, 341 

symptoms of, 341 
management of, with chicken-pox, 335 

with mumps, 337 

with typhoid fever, 338 

with whooping-cough, 335 

when sick with highly contagious 
disease, 325 
medicine, administering to, 318 
mildly contagious diseases of, 335 
mustard poultice for vomiting of, 343 
new-born (see New-Born Infant.) 

abdomen of, 224 

arms of, 224 

chest of, 22s, 224 

face of, 221 

gums of, 221 

hair of, 221 

hips of, 224 

legs of, 224 

position of, 224 

shape of, 223 

shoulders of, 224 

tongue of, 221 

trunk of, 223 
night clothes for, 269 
normal, 219 

breathing of, 310 

color of, 219, 220 



INDEX. 



443 



Baby — continued 
normal head of, 220 
pulse of, 309 
skin of, 219, 220 
nursing of, 228, 229 
outing clothes for, 271 
petticoat for, 269 
position of, when sleeping, 276 
rinsing, 264 
sack for, 269 
sick, 305 

appearance of abdomen of, 307 

breathing of, 310 

care of, 315 

difficulty in suckling of, 307 

dress in bed for, 316 

face of, 307 

feeding of, 316 

gestures of, 306 

head of, 307 

method of administering food to, 

317 

movements of, 306 

pulse of, 309 

toilet of, 315 
shirt for, 268 
short clothes for, 270 
shoulder blanket for, 269 
should sleep alone, 278 
size of, at different ages, 224, 225 
sleep, amount required by, 274 
socks for, 269 

spice plaster for vomiting of, 342, 343 
soda mint for colic of, 343 

for vomiting of, 343 
stockings for, 270 
systematic weighing of, 225 
taking out, 283 
teeth of, 221 
temperature of, 307, 308 
thirst of, 229 

time baby should sleep, 276 
tongue of, 307 
toys for, 288 
urination of, 226 
vomiting of, 340 

weight of, at different ages, 224, 225 
with whooping-cough should never be 

left alone, 336 
wrapper for, 269 

BACKACHE . . 

causes of, 353 

temporarv treatment of, 353 
BANDAGE 

abdominal, application of, after labor, 
208 



abdominal, during pregnancy, 163 
for pendulous abdomen, 352 
occlusive, 173 

application of, after labor, 208 
T-bandage, how applied, 371 

how made, 370 
BARLEY-WATER 
how prepared, 342 
in intestinal disorders of infants, 341 

BARRENNESS 

(See Sterility.) 
BASKET 

baby's, 178 

how to make, 178 

BASKETBALL 
as an exercise, 90 

BASSINET 

description of, 278 

how to make, out of clothes basket, 
278-279 

BATH 
articles required for baby's, 262-263 
baby's, 262-265 
cleansing, 35 
cold, 36 
full, 37 
half, 37 
shower, 38 
sponge, 38 
cool, in intestinal disorders of infancy, 

343 
curative, 39 
directions for cold, 38 
disinfectant, 330 

foot, for relief of headache, 351 
forms of, 37 
hardening, 36 
for consumptive, 340 
hardening effect of cold, 39 
hip, for relief of headache, 351 
hot, in intestinal disorders of baby. 3 ;;, 
hygienic, 36 

method of giving baby's, 264 
preparation of baby's, 263 
reaction after. ^y, 38 
sea, 39 
shower, 38 
sitz, 351 
sponge, 38 

sponge, for older children. 265 
surf, for child. 266 
temperature of water for baby's, 263 
Turkish. 30 



444 



INDEX. 



BATH-APRON, 263 

BATHING 

(See Bath.) 

after contagious disease, 330 
for consumptive, 340 
methods of, for baby, 264 

for older children, 265 
rules of, for baby, 263 
sea, for children, 266 
the baby, 262-265 
the ears, 42 
the face, 41 

the new-born infant, 262 
the sick baby, 315 

child, 315 

BEANS AS FOOD, 80 
BEAUTY 

appreciation of, 26 

basis of, 25 

bathing as a means to, 33 

depends upon health, 30 

how to preserve, 31 

ideas of, in different countries, 25, 26 

in dress, 68 

man's idea of, 25 

modern idea of, 27 

standard of, 25 

youth not necessary to, 29 

BED 

airing of baby's, 281 

care of baby's, 281 

changing of baby's, 281 

for baby, 278 

for confinement, 276 

getting out of, after labor, 210 

how to make baby's, 280 

in health, 85 

in sick-room, 313 

nermanent 176 

position in, after labor, 210 

temporary, 176 

BED-BOARD, 314 

BED CLOTHES 

arranged as permanent bed, 176 

as temporary bed, 176 
disinfection of, in contagious diseases, 

326 
for baby, 280 

how to keep, on baby, 280 
in health, 85 
in sick-room, 313 



BED-CRADLE, 314 
how to improvise, 314 

BED-REST, 313 
how to improvise, 313 

BED-ROOM 
(See Sick-room.) 
artificial lights in, 281, 282 
flowers and plants in, 281 
necessity of fresh air in, 86, 281 

BEDSIDE TABLE, 314 

BEEF-JUICE 

how to make, 260 

BEETS AS FOOD, 80 

BENDING 

forward and backward, 61 
to side, 61 

BEVERAGES 

the different, 81 

BIBS, 271 

BICHLORIDE OF MERCURY, 330 

BINDER 

abdominal, after confinement, 177 
application of, after confinement, 208 
baby's, 268 
mammary, forms of, 214 

how to make, 214 

use of, 214 

BLACK 
hair in relation to dress, 68 

BLONDE 
cool, in relation to dress, 70 
golden, in relation to dress, 70 

BODY 

development of mind at expense of, 381 
disinfection of, after death from con- 
tagious disease, 333 
ignorance as to names of different 
parts of, 348 

BOILING 

as a means of disinfecting clothes, 332 
water to disinfect bowel evacuations. 
338 



INDEX. 



445 



BOTTLE 
care of, 255 
for infant during its first week, 251 

during its second week, 251 

during its third week, 251 

from fourth to sixth week, 251 

from sixth to eighth week, 252 

at two months, 252 

at three months, 252 

at four months, 252 

at five months, 253 

at six months, 253 

at seven months, 253 

at eight months, 253 

at nine months, 254 

from 10 to 10^ months, 254 

from 10V2 to 11 months, 264 
heating baby's, 256 
how often to give to infant, 254 
how to cleanse, 255 
how to give, 256 
preparing baby's, 247 
selection of, 255 

BOWELS 
(See Feces.) 

attention to, after labor, 213 
during lactation, 213 
in contagious diseases, 327 
cleansing of baby after movement of, 

265 
color of evacuations in diarrhea of in- 
fants, 341 
consistency of evacuations in diarrhea 

of infants, 341 
number of movements in diarrhea of 

infants, 341 
of baby, 226, 310, 311 
training child in control of, 293 

BOWLING AS AN EXERCISE, 90 

BREAKFAST 
for baby, 258, 259 
for baby over two years, 261 

BREAST-FEEDING 

(See Nursing.) 
BREAST PUMP 

use of, 213 

BREASTS 

care of, during lactation, 213 

during pregnancy, 165 

during the puerperium, 213 
changes in, after labor, 195 

during pregnancy, 153 
emptying of, during lactation, 213 



supporting, by binder, 214-215 
treatment of caked, 216 

of congested, 215 

of distended, 215 

BREATHING 
exercises, 60 

BROTH 

how to prepare, 258, 259 
BROWN 

hair in relation to dress, 69 

BRUSH 
cleansing hair-brush, 48 
for hair, 47 
teeth, 45 

BUDS 
as form of reproduction, 151 

BUTTER AS A FOOD, 76 

CALCULATIONS 
for date of confinement, 187 

CALOMEL 
may always be given at beginning of 
any illness, 343 

CAP 

for nurse in contagious diseases, 328 
CARBOLIC ACID 
and soap solution for disinfecting 

linen, 326 
for disinfecting body after death, 333 
bowel movements, 327 
feces, 327, 338 
instruments, 329 
sputum, 327, 338 
urine, 327 
woodwork, 329 

CARBOLIC-SOAP SOLUTION 
disinfecting linen with, 327 
how to prepare, 326 

CANOEING AS AN EXERCISE, 89 

CARRIAGE 
exercises for developing a graceful 
carriage. 57 

CARROTS AS A FOOD, 80 

CASEIN 

in human and cow's milk, compared. 243 



446 



INDEX. 



CASTOR OIL 
may always be given at beginning of 
any illness, 343 

CATARRH 
of neck of womb as cause of leucor- 
rhea, 356 

CATHARTIC 

for relief of headache, 351 
CELLS 

everything composed of, 150 

kinds of, 151 

CEREALS AS FOOD, 79 
CERVICAL CANAL 

description of, 97 
CERVIX 

anatomy of, 97 

description of, 97 

CESSPOOL 

disinfection of, 333 
CHAFING 

treatment of, 265 
CHALK MIXTURE 

for diarrhea of baby, 343 
"CHANGE OF LIFE" 

(See Menopause.) 
CHAPPED HANDS 

cause of, 43 

treatment of, 43 
CHARACTER 

molding of in mother's hands, 292 

of pain, 349 

CHARACTERISTICS 

physical, of woman, 99 
CHEESE AS A FOOD, 76 
CHICKEN-POX 

management of child with, 335 

nature of, 335 

CHILD 

age at which it learns to talk, 298 

a great imitator, 294 

at kindergarten, 302, 303 

at school, 303 

at the table, 301 

backward, 303 

bathing, after contagious disease, 330 

bathing of older, 265 



before company, 301 
bowel movements of, 310 
breathing of, 310 

choice of stories told to, 300, 301 
common affections of, 323 
companionship of other children ne- 
cessary to, 302 
conformity of chest in, 307 
development of, 152 
education of, 302 
feeding of unconscious, 316 
food of young, 260, 261 
games for, 290, 291 
gentleness in dealing with, 294 
giving enema to, 321 
habits of order and neatness in, 298 
home-made toys for, 288, 290 
how to deal with, 293 
how to enforce obedience in, 296 
how to take temperature of, 308 
imagination of, 295 
in society of elders, 301 
intestinal disorders of, 340 
kindness in dealing with, 204 
making truthful, 295 
management of, in chicken-pox, 335 

in consumption, 339, 340 

in mumps, 337 

in typhoid fever, 338 

in whooping-cough, 336 

sick, 311 

when sick with contagious disease. 

325 
medicine, administering to, 318 
molding character of, 292 
normal breathing of, 310 

pulse of, 309 
nourishment of within the womb. 153 
pets of. 299 
pulse-rate of, 309 

punishments in training of, 297, 298 
questions of, 294 
requires pleasure, 294 
sensitiveness of, 293 
sick, 305 

appearance of face of, 307 
head of, 307 

breathing-rate of, 310 

care of, 315 

character of cough of. 306 

dress in bed for, 316 

feeding of, 316 

movements of, 306 

position assumed by, 306 

pulse of. 309 

temperature of, 307 

toilet of, 315 



Child— continued 
sick, tongue of, 307 
special school for mentally deficient, 

303 
temper of, 295 
the spoiled, 296, 297 
threats in training of, 297 
training the, in conduct, 204 

in control of bladder, 293 

in control of bowels, 293 

in use of money, 298 
training of backward, 303 

of mentally deficient, 303 
treating nose of, 320 

throat of, 320, 321 

CHILD-BIRTH 

(See Confinement, Labor.) 

CHILD-LABOR, 83 

CHILDLESSNESS 
(See Sterility.) 

CHLORIDE OF LIME 
how to prepare solution of, 326 
sheet moistened with solution of, 326 
solution of, for disinfecting body after 
death, 333 
for disinfecting bowel movements, 

. 327, 338 
for disinfecting cesspool, 333 
for disinfecting dishes, 327 
-for disinfecting eating utensils, 328 
for disinfecting feces, 327 
for disinfecting hands, 328 
for disinfecting instruments, 329 
for disinfecting left-over food, 328 
for disinfecting privy, 333 
for disinfecting sputum, 327, 338 
for disinfecting urine, 327 
for disinfecting vessels, 327 
for disinfecting wood- work, 329 
for wiping wood-work after disinfec- 
tion, 331 

CHLORINATED LIME 
(See Chloride of Lime.) 

CHLOROSIS 
absence of menstruation in, 362 
painful menstruation in, 365" 

CHOCOLATE AS A FOOD, 82 
CLIMBING AS AN EXERCISE, 88 
CLOTHING 

best material for infants', 267 

children's, 272 



INDEX. 447 

children's, for out of doors, 272-273 
covering the, with gown when nursing 

contagious disease, 328 
disinfection of, 332 

in contagious diseases, 326-327 
effect of suspending from waist, 379 
for baby, 179, 267-272 

with intestinal disorder, 342 
for infant, 267 
material of, 64-66 
non-inflammable, 72 
objects of, 64 
removing stains from, 314 
short, 270 
waterproof, 72 

COACH 
for baby, 285 
strap for, 285 

COCOA AS A BEVERAGE, 82 
COFFEE AS A BEVERAGE, 81 
COLD 

catching, 36, 379 

bath, 36 

explanation of catching, 379 

how caught, 378 
COLD CREAM 

use of, on face, 42 
COLIC 

position of child with, 342 

relieved by enema, 343 

soda-mint given for, 343 

COLOR 
as an element of beauty, 28 
gradations in, 28 
influence of, in garments, 66 
of dress for different types, 68 

COLOSTRUM, 230 

COMB 

cleansing, 48 

proper kind of, for hair, 48 

COMPLEXION 
care of, 41 
different color of dress in accordance 

with, 68 
types of, 68 
during pregnancy, 157 

COMPRESS 

cold stimulating, for relief of headache. 

351 
cooling, for relief of headache, 351 



INDEX. 



Compress — continued 

hot, for relief of headache, 351 

how to prepare cold stimulating, 351 
cooling, 351 

result of faulty application of, 391 
CONCEPTION 

danger of preventing, 385 

physiology of, 152 

preventing, a cause of women's dis- 
eases, 385 
CONFINEMENT 

(See Labor.) 

bed for, 176 

engaging nurse for, 180 
physician for, 180 

how to calculate day of, 186-189 

preparation of patient for, 180 

room for, 175 

things needed for, 177 

CONSANGUINITY 
in its relation to marriage, 139 

CONSTIPATION 
attention to diet in, 357 
chronic, a cause of women's diseases, 

385 
diet for, 357, 358 
exercise for, 357 
massage of abdomen for, 357 
medicine of little use in, 357 
treatment of, 357 
water internally for, 357 

CONSTRICTION 

causes displacement of womb, 379 
dyspepsia, 379 

how to avoid, 66 

impairs breathing, 379 

interferes with proper function of or- 
gans, 379 

may lead to consumption, 379 

of abdomen in pregnancy may produce 
miscarriage, 380 

of dress, harm of, 379 

result of, 379 
CONSUMPTION 

(See Tuberculosis.) 

a cause of leucorrhea, 356 

bathing of person with, 340 

care of patient with, 339, 340 
of sputum in, 338, 339 

diet of patient with, 340 

exercise of patient with, 340 

heredity sometimes a factor in, 137 

how acquired, 137 



life of person with, 339, 340 
marriage and, 138 
those liable to, 137 
treatment of person with, 340 

CONTAGION 
how carried, 324 
in mildly contagious diseases, 335 

CONTAGIOUS DISEASES 
highly, 324 
nature of, 324 
management of, 325 

CONTROL 
of bladder in child, 293 
bowels in child, 293 

CONVALESCENCE 
danger from scaling during, 329 
from contagious disease, 329 

COOKING 
meats, 77 
training in, 128 

CORD 

(See Umbilical Cord.) 
CORPSE 

disinfection of, 333 
CORROSIVE SUBLIMATE 

(See Bichlorid of Mercury.) 

for disinfecting body after death, 333 

COTTON 
a good heat conductor, 65 
a poor absorbent of moisture, 65 

COUGH 
character of baby's, 306 

COURTSHIP 
according to modern ideas, 118 
in America, 119 
in Continental Europe, 119 
cultivation of mutual esteem and 

friendship during, 124 
English idea of, 119 
province of, 124 

COW'S MILK 
(See Milk, cow's.) 

CRAB 
meat as a food, 78 

CRADLE 
disadvantage of, 279 



INDEX. 



449 



CREAM 

as a food, 76 
CREEPING APRON, 271 
CRIB 

proper bed for child, 280 

CRIMINALITY 
a form of degeneracy, 136 

CRIMINAL OPERATION 
danger of, 369, 384, 385, 390 

CROUP 
membranous, 325 

CRY 

character of baby's, 305 

significance of different kinds of 
baby's, 305 
CUP 

for sputum, 336, 338, 339 
CURVATURE 

definition of, 27 
DANCING AS AN EXERCISE, 90 
DANDRUFF 

shampooing for, 49 
DANGER 

in patent medicine, 343, 358 
DANGER-SIGNALS 

recognition of, 169 

symptoms that are, 350 

DAY 

length of working, 84 
DEAF MUTISM 

in its relation to marriage, 136 
DEATH 

from contagious disease, care of body 
after, 333 

rules concerning, 333 

DECEIT 
avoidance of, in dealing with children, 
3i8 
DEEP KNEE BEND, 62 

DEFORMITIES 
avoidance of, 52 
causes of, 53 
how acquired, 52 
to detect, 54 
29 



how to prevent, 55 
prevention of, 52 
produced by school, 53 
recognition of, 54 

DEGREE 

of pain, 349 
DELIVERY 

(See Labor.) 

management of, 204 

DESQUAMATION, 329 

(See Scaling.) 
DEVELOPMENT 

of mind at expense of body, 381 
DIABETES 

a cause of itching, 356 
DIAPERS 

how to cleanse, 268 

material for, 268 

supporters for, 270 

DIARRHEA 
calomel for, 343 
castor oil for, 343 
chalk mixture for, 343 
in intestinal disorders of infancy, 340 

DIET 
for baby with intestinal disorder, 341 
constipation, 357, 358 
consumptives, 240 
nursing mother, 211 

DINNER 

for 1 year old baby, 258 
baby between 18 months and 2 years, 
259 
between 2 and 3 years, 261 

DIPHTHERIA 

bacteriological examination of throat 

necessary in, 329 
description of, 325 
negative culture in, necessary before 

patient can go out, 329 
when a patient with, may go out, 329 

DISCHARGES 

bloody discharge from vagina, 356 

to be viewed with concern, 356 
cause of itching, 356 
white, from vagina, caused by : 

consumption, 354 

displacement of neck of womb, 354 

general ill health, 354 



450 



INDEX. 



Discharges — continued 
white, from vagina, caused by: 

gonorrhea, 354 

inflammation of neck of womb, 354 

seat worms, 354 

syphilis, 354 

tear of neck of womb, 354 
yellow, from vagina, caused by go- 
norrhea, 355 
DISEASES 
carrying of, with infected hand, 337 
combatted by means of good nourish- 
ing food, 380 
highly contagious, 324 

management of, 325 

nature of, 324 
intestinal, of infancy, 340 
mildly contagious, 335 
contagion in, 335 
of women caused by: 

artificial termination of pregnancy, 

384, 385 
chronic constipation, 385 
development of mind at expense of 

body, 381 
improper food, 380 
improprieties of dress, 378-380 
imprudence during menstruation, 383 
lack of proper exercise, 378 
mismanagement after labor, 383, 384 

during labor, 383, 384 
neglect of hygienic rules, 378 
unhygienic marital relations, 385 
want of sufficient rest, 280 
of women, majority of causes of, pre- 
ventable, 385, 386 
physician must be consulted in, 387, 

3?8 
prevention of, 387 
symptoms of, 347 
treatment of symptoms of, 347 
women have no inherent tendency 
to, 385 

DISHES 

disinfection of, in contagious diseases, 
327, 328 
in typhoid fever, 338 

DISINFECTION 
airing room after, 331 
at city disinfection station, 332 
best method of, 330 
cleansing room after, 331 
different methods of, 330 
foolish when not thorough, 333 



frequent, of woodwork in contagious 

diseases, 329 
method of, in room, 331 
of bed-clothes, 326 
bedding, 332 
body after death from contagious 

disease, 333 
bowel evacuations, 327 
cesspool, 333 
clothes by boiling, 332 
clothing, 326, 332 

at home, 332 
dishes, 327, 328 
feces, 327 
hands, 328 
after attending to typhoid fever 
patients, 338 
instruments in contagious disease, 

329 
left-over food, 328 
linen, 326 
mouth, 329 
nose, 329 
nurse before leaving sick-room in 

contagious disease, 328 
patient's body in contagious disease, 
329 
skin in contagious disease, 329 
privy, 333 
room, 330 

sputum, 327, 338, 339 
urine, 327 
vessels, 327 
sealing room during, 331 
thorough, always possible, 332 
with formaldehyde spray, 330 
formaldehyde vapor, 330 
sulphur, 330 

DISPLACEMENT 

of womb a cause of leucorrhea, 356 
a cause of sterility, 373 
caused by imprudence after labor, 
384 
DOUCHE 

a cause of leucorrhea, 354 

-pan, use of, 353 

for itching of vulva, 357 

hot, in treatment of leucorrhea, 355 

vaginal, for abdominal pain, 353 
DRAUGHTS 

prevention of, 372 
DRESS 

beauty in, 68 

during pregnancy, 162 



Dress — continued 



economy in, 127 
faulty methods of, 378 
for different types, 68 

infant, 269 

the world rather than for the home, 
142 
result of constriction in, 379 

DRINK, 73, 81 
drinking water, 81 

"DROPPING" 
as a premonitory sign of labor, 197 
explanation of, 154 
occurrence of, 154 

DRUNKENNESS 

an obstacle to marriage, 134 

frequent cause of idiocy and insanity, 
134, 135 
DURATION 

of pain, 349 
DYSMENORRHEA 

(See Menstruation, painful.) 
EARS 

care of, 42 
ECONOMY 

in dress, 127 
EDUCATION 

injurious effect of modern system of, 
381, 382 

in kindergarten, 302, 303 

in school, 303 

of children, 302 

EGGS } 76 
cooked, 76 
how to cook, 76 

how rendered most digestible, 76 
raw, 76 

EMBRYO 
appearance of, in miscarriage, 369 
expulsion of, in miscarriage, 368 

EMERGENCIES 

treatment in, 347, 348 
ENEMA 

for colic of baby, 343 

giving, to child, 321 

EPILEPSY 
a bar to marriage, 136 



INDEX. 451 

EXERCISE 
avoidance of, during menstrual period, 



378 

baby's first, 284 
basketball as an, 90 
bending forward and backward as an, 
61 

to the side as an, 61 
bicycling as an, 88 
bowling as an, 90 
breathing as an, 59 
canoeing as an, 89 
climbing as an, 88 
dancing as an, 90 
deep knee bend as an, 62 
elevating the shoulders as an, 61 
excessive, may lead to ill health, 378 
fencing as an, 90 
floor exercise, 62 
for baby, 283 

constipation, 357 

developing figure, 59 

developing graceful carriage, 57 
forward drop as an, 63 
golf as an, 89 
horseback riding as an, 88 
lack of, a cause of diseases of women. 

378 
lawn tennis as an, 89 
punching the bag as an, 90 
rowing as an, 89 
running as an, 88 
swimming as an, 89 
tether tennis as an, 89 
toe-raising as an, 61 
twisting as an, 61 
walking as an, 88 
windmill, 61 

EXPRESSION 

importance of, in beauty, 29 
EXTERNAL OS 

description of, 97 
EXTERNAL REMEDIES 

in intestinal disorders of infant, 342 
EYES 

at birth, 221 

care of new-born infant's. 204 

examination of, for headache, 351 
FACE 

appearance of. at birth, 221 
in sick child. 307 

bathing the. 41 

powders, 42 

massage of, 42 



45 2 INDEX. 

Face — continued 

use of cold cream on, 42 

soap on, 41 
washing baby's, 264 

FALLOPIAN TUBES 

acute inflammation of, due to septic in- 
fection, 374 

chronic inflammation of, due to gonor- 
rhea, 374 

description of, 97 

disease of, a cause of sterility, 374 

FAMILY 
origin of the, 117 

FAT 

diminishing the, in human milk, 232 
increasing the, in human milk, 232 
percentage of, in cow's milk, 243 
in human milk, 230, 231 

FEARS 

of children, 295 
FECES 

(See Bowels.) 

disinfection of, 327 
in typhoid fever, 338 

FEEDING 
artificial, of infants, 241 
breast, 228-240 

care of baby's mouth after, 234 
during the first few days of life, 233 
frequency of bottle feeding, 254, 255 

of breast feeding, 234 
high mortality due to artificial, 241 
importance of percentage, 244 
mixed, 236 
of infants, 228 

older babies, 258 

sick babies, 316 

sick child, 316 

regularity in, 233 
result of irregularity in, 234 

FEMALE ORGANS 
in birds, 94 
fish, 94 

higher animals, 95 
plants, 94 
woman, 96-99 

FENCING AS AN EXERCISE, 90 
FETUS 

heart sounds of, 160 

movements of, felt, 159 



FEVER 
in intestinal disorders of infancy, 341 
scarlet (see Scarlet Fever), 
typhoid (see Typhoid Fever). 

FIGURE 
exercises for developing the, 59 
how to improve the, 55 
measurements of the ideal, 52 
standard of beauty in the, 51 
use of housework in developing the, 58 

FIRMNESS 

requisite in the mother, 296 
FISH, 78 

shellfish as a food, 78 
FLASK 

pocket, for sputum, 339 
FLOODING 

a serious condition, 365 

demands physician's attention, 365 

FLOOR 
exercises, 62 

FONTANELLE 
anterior, 221 

depression of, in wasting of infant, 341 
in health, 221 
posterior, 221 

FOOD 

animal, 75 

care of, in contagious diseases, 328 

character of, 7s 

different kinds of, 75 

disinfecting left-over, 328 

during pregnancy, 161, 162 

puerperium, 211 
eaten by women in rural districts, 380 
for infants at different ages, 250 

first week of life, 251 

second week of life, 251 

third week of life, 251 

fourth to sixth week, 251 

sixth to eighth week, 252 

two months, 252 

four months, 252 

five months, 253 

six months, 253 

seven months, 253 

eight months, 253 

nine months, 254 

10 to io l A months, 254 

10^ to 11 months, 254 



INDEX. 



453 



Food — continued 
for baby II to 12 months old, 258 

1 year to 13 months old, 258 
14 to 15 months old, 259 

16 months old, 259 

17 to 18 months old, 259 

18 months to 2 years old, 259 

2 to 3 years old, 260, 261 
for nursing mother, 211 
for sick baby, 316 

for sick child, 316 

good nourishing, necessary to main- 
tenance of general health, 380 
heating the baby's, 256 
how infected in typhoid fever, 337 

often to give to infants, 254 

to administer to sick child, 317 

to prepare, 75 
improper, 380 

a cause of diseases of women, 380 
object of, 73 
of older babies, 258 
patent, 257 

preparation of the baby's, 246 
proprietary, 242, 257 
relative indigestibility of different ani- 
mal foods, 78, 79 
source of contagion in typhoid fever, 

too much, eaten in cities, 380 

vegetable, 79 
FORMALDEHYDE 

(See Formalin.) 

amount of, required for disinfecting 
room, 330 

for disinfecting room, 330 

method of disinfecting with, 331 

solution of, for disinfecting clothes, 
332 

vapors of, for disinfecting clothes, 332 
FORMALIN 

(See Formaldehyde.) 

amount of, required for disinfecting 
room, 330 

sheet wet with, 326 

solution of, for disinfecting hands, 328 
mouth, 329 
room, 330 
FORWARD DROP, 63 
FOUNTAIN SYRINGE 

for giving vaginal douche, 353 

use of, in giving enema, 321 
FREQUENCY 

of pain, 349 



FRUITS AS FOOD, 81 

GAMES 
finger, 286-287 
for amusing child, 286 
exercising child, 286 
that exercise and amuse older children, 
290-291 
GAS 

in sleeping room, 281 

GERMS 
a talk on, 198 
disease, 198 

GOLF AS AN EXERCISE, 89 
GONORRHEA 
a cause of leucorrhea, 354 
of sterility, 374 

GOWN 

for nurse in contagious diseases, 328 
GRACE 

exercises for developing, 57 
GRAY 

hair in relation to dress, 71 
GYNECOLOGY, 347 
HABITS 

necessity for correct habits in mentally 
deficient children, 303 

of order and neatness in child, 298 

HAIR 

anatomy of, 47 

at birth, 221 

blonde, 70 

black, 65 

brown, 69 

brushing the, 47 

care of the, 47 

care of the baby's, 365 

cleansing of child's, 315 

combing the, 48 

covering the, with cap when nursing 

contagious disease, 328 
curling the, 49 
dressing the, 50 
gray, 71 
-brush, 47 
of baby, 221 
red. 68 

ridding, of nits and lice, 315 
shampooing the, 49 
to preserve the, 47 



454 



INDEX. 



HANDKERCHIEFS 

disinfection of, in contagious diseases, 
327 
HANDS 

disinfection of, 328, 338 

HAPPINESS 

how preserved in married life, 141 

influence of personal appearance on 
marital happiness, 141 

promoted by avoidance of contention, 
144 
HEAD 

appearance of, in sick child, 307 

development of, in infant, 220 

pain in (see Headache). 

shape of, in new-born infant, 220 

HEADACHE 
attention to hygienic rules for, 351 
cathartic for, 351 
cooling compress for, 351 
examination of eyes for, 351 
hot compress for, 351 
hot foot bath for, 351 
hot sitz bath for, 351 
how to relieve, 351 
menthol pencil for, 351 
-powders, danger of, 359 
stimulating cold compress for, 351 

HEALTH 

(See Hygiene.) 

an essential of beauty, 30 

attention to rules of, for leucorrhea, 

355 
for relief of headache, 351 
bathing as a means to, 33 
ill-health a cause of leucorrhea, 354 
necessity of preserving general, 389 
of unborn, providing for, 132 
preservation of, only preventive of 

cancer, 389 
HEAT 
application of, for abdominal pains, 

352, 353 
HEMORRHAGE 

character of, in miscarriage, 368 
HEREDITY, 132 
exchange of confidences concerning, 

before marriage, 133 
in instinctive criminality, 136 
in its relation to marriage, 132 
in one form of deaf-mutism, 136 
physician should be consulted before 

marriage when it exists, 133 



results of disregarding, in marriage 

133, 134 
sometimes a factor in consumption, 137 
where its taint is slight, 134 

HORSEBACK RIDING 

as an exercise, 88 
HOSPITAL 

advantage of, in contagious disease, 332 
HOT-WATER BAG 

for abdominal pain, 352 
HOUSEWORK 

proper dress for, 59 

utilized in developing the figure, 58 

HYGIENE 
attention to rules of, for absence of 
menstruation, 363 
for relief of headache, 351 
neglect of rules of, a cause of diseases 
of women, 378 

HYPOCHONDRIASIS, 348 

one cause of, 348 
ICE-BAG 

for abdominal pain, 352 
ILL-HEALTH 

cause of leucorrhea, 354 
IMAGINATION 

of children, 295 
INCUBATOR 

how improvised, 205 

use of, 205 

INDIGESTION 

cause of, 73, 74 
INFANT 

ages at which it notices, walks, talks, 
etc., 227 

bathing, 262-265 

binder for, 268 

bowel movements of, 226 

cap for, 269 

care of asphyxiated, 206-208 

care of premature, 205 

calomel may be given to, 343 

castor oil may be given to, 343 

chalk mixture for diarrhea of, 343 

cloak for, 269 

clothing for, 267 

coat for, 269 

common affections of, 323 

danger of giving laudanum to, 343 
opium to, 343 



INDEX. 



455 



Infant— continued 
danger of giving paregoric to, 343 

soothing syrup to, 343 
diapers for, 268 
diarrhea of, 341, 342 
dress for, 269 
enema for colic of, 343 
feeding of, 228-261 
first airing of, 283 
giving medicine to, 318 
mustard plaster for vomiting of, 343 
mustard poultice for vomiting of, 343 
new-born 
abdomen of, 224 
arms of, 224 
bathing of, 262 
care of, 204-206 
chest of, 223, 224 
development of head of, 220 
face of, 221 
gums of, 221, 222 
hair of, 221 
hips of, 224 
legs of, 224 
position of, 224 
shape of head of, 220, 221 
shoulders of, 224 
night clothes for, 269 
normal, 219-227 
appearance of, 219, 224 
color of, 219, 220 
skin of, 219, 220 
petticoat for, 269 
proper method of holding, 283 
sack for, 269 
shirt for, 268 
shoulder blanket for, 269 
shoulders of new-born, 224 
sick, 305 

sick with intestinal disorders, 340 
care of, 341 
clothing for, 342 
cool bath for, 343 
diet for, 341 

external remedies for, 342 
fever in, 341 
hot bath for, 343 
medicine for, 343 
pain in, 341 
rest for, 342 
> wasting in, 341 

size of. at different ages, 224, 225 
socks for, 269 
soda mint for colic of, 343 
spice plaster for vomiting of, 342, 343 
symptoms of disorders of, 340 



systematic weighing of, 225 

teeth of, 221 

thirst of, 229 

tongue of, 221 

urination of, 226 

vomiting of, 341 

weight of, at different ages, 224, 225 

wraps for, 269 

INFECTION 

description of, 198-199 

of birth canal, 199 

prevention of, 200, 209 
INJECTION 

(See Enema.) 

giving of large injection, 321 
INNOCENCE 

to preserve innocence, 113 
INSANITY 

caused often by drunkenness, 134 
INSOMNIA 

prevention of, 86 
INTERMITTENCE 

of pain, 350 
INTERNAL OS 

description of, 97 

INTESTINAL DISORDERS OF IN- 
FANCY 

clothing in, 342 

cool bath in, 343 

diarrhea in, 340, 341 

diet in, 341 

external remedies in, 342 

fever in, 341 

hot bath in, 343 

management of, 341 

mustard plaster for, 343 
poultice for, 343 

pain in, 341 

spice plaster for, 342, 343 

symptoms of, 340 

vomiting in, 340 

wasting in, 341 
ISOLATION 

how long to continue, 329 

importance of, 325 

linen during, 326 

meaning of, 325, 326 

removal from. 330 

sick-room during. 326 

when complete isolation is impossible 
331 

when necessary, 325 



456 
ITCHING 
of vulva, 356 

causes of, 356 

powders for, 357 

treatment of, 356, 357 

KINDERGARTEN, 302, 303 

LABOR 

(See Confinement.) 

after labor (see Puerperium). 

anesthetic during, 203 

care of mother after, 209-216 

during third stage of, 208 
causes of, 185 
child-labor, 83 
definitioa of, 189 
diagnosis of, 197 
diet during first stage of, 203 
duration of, 198 
first stage of, 190-192 
management of, 196 

first stage of, 202 

second stage of, 203 

third stage of, 208 
mismanagement after, a cause of 
women's diseases, 383 

during, a cause of women's diseases, 
383 
observance of prudence and care after, 

390 
observance of prudence and care dur- 
ing, 390 
physiology of, 185 
second stage of, 192-193 
surgical cleanliness the guiding factor 

throughout, 198 
three stages of, 189 
third stage of, 193 
when to expect, 187-189 

LABORATORIES 
milk, 245 

LABOR-PAINS, 197, 190 
LACERATION 
(See Tear.) 
of neck of womb a cause of leucor- 

rhea, 354 
prompt repair of, a preventive of dis- 
ease, 391 
unrepaired, a cause of disease of 
women, 384 
a cause of sterility, 373 
LACTATION 
care of breasts during, 213 
care of nipples during, 214 



INDEX. 



diet during, 211 

emptying of breasts during, 213 
life during, 211-212 
use of mammary binder during, 214 
variations in composition of milk dur- 
ing, 231 

LARKSPUR 

as hair wash for lice and nits, 315 
LAUDANUM 

danger of giving to baby, 343 

LAWN TENNIS AS AN EXERCISE, 

89 
LEUCORRHEA 

a cause of sterility, 374 
attention to hygiene for, 355 
caused by consumption, 354 

displacement of womb, 354 

general ill-health, 354 

gonorrhea, 354 

inflammation of womb, 354 

seat-worms, 354 

syphilis, 354 

tear of womb, 354 
causes of, 354 
hot douches for, 355 
recognition of, 355 
treatment of, 355 

LICE 

ridding hair of, 315 
LIGAMENTS 

supporting the uterus, 97 
"LIGHTENING" 

explanation of, 164 

occurrence of, 154 

LIME 

chloride of (see Chloride of Lime), 
chlorinated (see Chloride of Lime), 
milk of, for disinfecting left-over 
food, 328 
how prepared, 328 

LINEN 
disinfection of, in contagious diseases, 
326 
in typhoid fever, 338 
good conductor of heat, 65 

LIQUOR AMNII, 190 

LOBSTER AS A FOOD, 78 
LOCATION 
of pain, 348 



INDEX. 



457 



LOCHIA 
amount of, 194 
description of, 193 
lochia alba, 194 
lochia rubra, 194 
lochia serosa, 194 
odor of, 194 

LOVE 

as true affection, 122-123 

kept by art, 140 

nature of, 120 

philosopher's definition of, 120, 121 

poet's view of, 120 

steadier sentiment of, 121, 122 

the basis for marriage, 119 

transient as passion, 121 
LYING-IN PERIOD 

(See Puerperium.) 
MANICURING, 46 
MARGARIN, 76 
MARITAL RELATIONS 

excess in, result of, 385 

unhygienic, a cause of women's dis- 
eases, 385 

MARKETING 
training in, 127 

MARRIAGE 

basis of happiness in, 140 

by barter, 118 

by capture, 117 

consanguineous, 139 

considerations before, 124 

consult physician before, when hered- 
itary disease is in family, 133 

consumption and, 138 

customs among different peoples, 117 

danger of early, 129 

deaf-mutism in its relation to, 136 

drunkenness an obstacle to, 134, 135 

epilepsy a bar to, 136 

exchange of confidence concerning 
family disease before, 133 

for wealth or position, 125 

heredity in its relation to, 132 

influence of personal appearance on 
happiness after, 141 

insanity a bar to, 135 

love the basis for, 119 

misery caused by early, 130 

money question should be considered 
before, 124 

of syphilitics, 138 



origin of, 117 

proper age for, 128 

results of disregarding heredity in, 733, 

training of a girl for, 126 

unhappy when based on passion, 123 

wrong standard of requirements in, 125 

MASSAGE 
of abdomen for constipation, 357 
of face, 42 
of scalp, 48 

MATERIAL 
advantages of different kinds of, 65 
for underwear, 65 
that best absorbs moisture, 65 
that best preserves heat, 64 

MATERNAL IMPRESSIONS 
discussion of, 164 
regulation of, 164, 165 

MEALS 
hours for, 74 
rest after, 75 
sufficient time necessary for, 74 

MEASLES 
German (see Rubella), 
greasing body during scaling from, 329 
nature of, 324 
seriousness of, 324 
symptoms of, 324 

MEATS 
how to boil, 77 

broil, 77 

fry, 78 

prepare, 76 

roast, 77 
meat juice (see Beef Juice), 
raw, 76 

MEDICINE 
how to administer, to baby, 318 

child, 318, 319 

infant, 318 
in intestinal disorders of infant, 343 
patent, dangerous for women. 358-360 

dangerous for children and babies. 

343 
opium in. 343, 358 
should be prescribed by physician, 343 
that may be given by mother, 343 

MENOPAUSE 
age at which it occurs. 167 



458 



INDEX. 



Menopause — continued 
danger signals not to be confused with, 

169 
hygiene of, 176 
importance of familiarity with normal 

phenomena of, 169 
physiology of, 169 

MENSTRUAL FLOW 
(See Menstruation.) 
absence of (see Menstruation, ab- 
sence of), 
character of, 108 
duration of, 108 
painful, 365 
profuse, 365 

a serious condition, 365 

demands physician's attention, 365 
quantity of, 108 
scanty, 364 
sudden checking of, 353, 364 

treatment of, 364 

MENSTRUATION 
abnormal symptoms in connection 

with, 170 
absence of, 361 

causes of, 361, 362 

from change of climate, 362 

hygiene in, 363 

in acute general diseases, 362 

in chronic general diseases, 362 

in mental disturbance 362 

in obesity, 362 

in overwork, 362 

symptoms accompanying, 363 

treatment of, 363 
avoidance of exercise during, 378 
causes of late onset of, 102 
cessation of, in pregnancy, 156 
delay in appearance of, 102 
disorders of, 36T 

due to modern system of education, 
382 
"Juration of, 108 
effect of, on milk, 232 
explanation of, 107 
final cessation of, 157 
flow during, 108 
hygiene of, no 
imprudence during, a cause of women's 

diseases, 383 
interval between, 109 
occurrence of, 107 
pain during, 109 
painful, 365 

causes of, 366 



painful, character of pains in, 366 

treatment of, 366 
profuse, 365 

quantity of discharge during, 108 
scanty, 364 
sudden checking of, 363, 364 

treatment of, 364 
suppression of, causes of, 361, 372 
symptoms exhibited during, 108, 109 
time of cessation of, 108 

of onset of, 107 
vicarious, 109, 364 

treatment of, 364 

MERCURY 
bichloride of (see Bichlorid of Mer- 
cury), 
bichloride of, disinfectant bath in, 330 

MILK 
affected by menstruation, 332 
care in selection of, 246 
composition of cow's, 243 

human, 230 
condensed, 242, 257 
conditions affecting the, 232 
difficulty of providing proper substi- 
tute for human, 242 
digestion of, 75 
fore-milk, 231 

formula for modified cow's, 244 
home modification of, 245 
how to drink, 75 

decrease quantity of human, 231 

increase quantity of human, 231 

modify fat of human, 232 

modify proteid of human, 232 

modify quality of human, 231, 232 

modify cow's, 242 

prepare peptonized, 257 

render more digestible and palatable, 
75-76, 316 
laboratories, 245 
products, 75 

mixtures for different ages, 250 
modifications of breast, 231 
modified cow's, best substitute for 

human, 244 
of ass, 242 

cow, 242 

goat, 242 

lime — how prepared, 328 
for disinfecting bowel evacuations, 

328 
for disinfecting left-over food, 328 

mare, 242 
peptonized, 257 



of 



Milk — con tinued 

percentage modification of cow's, 244 

percentage of fat in human, 230 
proteid in human, 230 
sugar in human, 230 

preparation of, for baby, 247 

quantity of human, 231 

reaction of cow's, 243 

results of feeding with condensed, 258 

substitutes for mother's, 242 

to change reaction of cow's, 243 

to destroy germs in, 243, 244 

varying composition of, during act of 
nursing, 231 
MIND 

development of, at expense of body, 
38i 
MISCARRIAGE 

after-treatment of, 371, 372 

appearance of ovum in, 369 

artificially produced, a cause 
women's diseases, 384, 385 

causes of, 367, 368, 380 

character of hemorrhage in, 368 

course of, 367 

danger of, 369 

expulsion of ovum in, 368, 369 

inevitable, treatment of, 370, 371 

invalidism caused by neglect after, 372 

observance of prudence and care after, 
390 
of prudence and care during, 390 

pain in, 368 

prevention of, 369, 370 

sickness caused by neglect after, 372 

signs of, 368, 369 

symptoms of, 368, 369 

threatened, 370 

to avert, 370 

treatment of, 370, 371 
MIXED FEEDING, 23 
MODESTY 

to preserve true, 1 13 
MONEY 

pocket, fo. wife, 146 

question to be considered before mar- 
riage, 124 

training child in use of, 299 
MORNING SICKNESS 

in pregnancy, 157 

prevention of, 162 
MOTHER 

changes in, during pregnancy, 154 

firmness a requisite in, 206 



INDEX. 459 

important duty of, to train child, 292 
molding of child's character in hands 

of, 292 
respect due a good, 148 
the mother "blessed," 149 

MOTHERHOOD 

woman's task, 148 
MOUTH 

disinfection of, 329 

wash for, 45 

MOUTH WASH, 45 
MUCUS 

present in bowel evacuations, 341 
MUMPS 

length of period of contagion in, 337 

nature of, 337 

MUSTARD PLASTER 

home-made, 343 
MUSTARD POULTICE 

how to make, 343 
NAILS 

care of, 45 

cleansing of, 46 

manicuring, 46 

removing stains from, 46 

NAPKINS 

disinfection of, in contagious diseases, 

327 
occlusive, after labor, 177 

NEGLECT 

after miscarriage a cause of unneces- 
sary sickness, 371 

NERVOUS SYSTEM 

alterations in, during pregnancy, 157, 
159 
NIGHT CLOTHES 
for baby, 269 
child, 273 

NIGHT-LAMP, 282 
NIPPLES 



anointing, 214 

appearance of, during pregnancy, 157 

care of, during lactation, 214 

care of rubber, 255, 256 

cleansing of rubber, 256 

preparation of. during pregnancy. 105 

proper kind of rubber, 255, 256 

selection of, 255, 26s 






4 6o INDEX. 

Nipples — continued 
treatment of, when chapped, 214 

when cracked, 214 

when depressed, 214 

when supersensitive, 214 
use of shield for, 214 
washing, 214 

NITS 

ridding hair of, 315 

NOON-HOUR 

how to be spent, 85 
NOSE 

care of child's, 266 

disinfection of, 329 

treating child's, 320 

NURSE 
action of, during labor, 202 
attire of, in contagious diseases, 328 
cap of, in contagious diseases, 328 
duties of, 182 
engagement of, 183 
gown of, in contagious diseases, 328 
monthly, 181 
overshoes of, in contagious diseases, 

328 
selection of, 182 
trained or graduate, 181 

NURSERY 

conveniences for, 179 
NURSING 

care of baby's mouth after, 234 

difficulty of, with sick baby, 307 

difficulty of providing proper substi- 
tute for, 242 

during first few days of life, 233 

frequency of, 234 

grouping of children's diseases from 
standpoint of, 324 

how baby should be held while, 234 

importance of, 228, 229 

of sick child and baby, 323 

regularity in, 233 

result of irregularity in, 234 

iules for, 233 
NURSING MOTHER 

care of breasts of, 213 
nipples of, 214 

diet for, 211 

emptying the breasts of, 213 

life of, 211, 212 

use of mammary binder by, 214 



OBEDIENCE 

how to enforce, in children, 296 
OBESITY 

absence of menstruation in, 362 

a cause of sterility, 374 

cause of, 73 

OBSERVE 

how to observe pain, 348 
OCCLUSIVE BANDAGE 

for confinement, 177 

how to apply, 208 

how to prepare, 177 

ONSET 
mode of onset of pain, 349 

OPERATION 
criminal, danger of, 369, 384, 385, 390 

OPIUM 
danger of, in treating babies, 343 
in patent medicines, 343, 358 
present in all soothing syrups, 343 

OVARY 
description of, 97 

disease of, a cause of sterility, 374 
in birds, 94 

fish, 94 

plants, 94 

woman, 94 

OVULATION 
connection with menstruation, 107 
definition of, 106 
duration of period of, 106 
phenomenon of, 106 

OVUM 
appearance of, in miscarriage, 368 
development of, 152, 153 
expulsion of, in miscarriage, 368 
formation of, 152 

OYSTERS, 78 
PAD 

absorbent, for confinement, 176 
PAIN 

at menstrual period, 365 
character of, 349 
degree of, 348 
diurnal, 350 
duration of, 349 
explanation of, 350 
headache, relief of, 350 



INDEX. 



461 



Pain — continued 
how modified, 350 
in abdomen, relief of, 352 

back (see Backache), 
cause of, 353 
temporary treatment of, 353 

intestinal disorders of infancy, 341 

miscarriage, 368 
intermittent, 349 
itself seldom treated, 350 
labor, 190 
location of, 348 

menstruation not normally accompa- 
nied by, 365 
mode of onset of, 348 
nocturnal, 350 
paroxysmal, 350 
periodic, 350 
remittent, 349 

temporary treatment of, 350 
to designate seat of, 348 
to observe, 348 
transmission of, 349 
when to be regarded as a danger sig- 
nal, 350 

PAINFUL MENSTRUATION 
(See Menstruation, painful.) 

PAINS 
after-pains, 194 
labor-pains, 190, 197 

PAREGORIC 

danger of giving, to baby, 343 
PARASITES 

ridding hair of, 315 

PARSNIPS AS FOOD, 80 

PASTEURIZATION 
of milk, 248, 249 
when necessary, 247 
when unnecessary, 247 
use of Arnold steam sterilizer for, 249, 
250 

PASTEURIZER 
Freeman, 249 

PATENT MEDICINES 
alcohol in, 358 
danger of, 343, 358 
opium in, 343 

PATIENT 
care of, 315 

PEAS AS FOOD, 80 



PELVIS 

description of, 99 
PERAMBULATOR 

for baby, 285 
PERITONITIS, 

origin of, 198 
PETS 

educational value of, in childhood, 299 
PETTICOAT, 269 

for infant, 269 

PHYSICIAN 
directions of, must be followed, 388 
must be consulted in women's diseases, 

387 
neglect of consulting, dangerous, 388 

PHYSIOLOGY 
of child-birth, 185 
pelvic organs, 96 
reproductive organs, 96 

PLACENTA 
expression of, 208 
expulsion of, 193, 208 
formation of, 153 
position of, 190 
structure of, 153 

PLEASURE 

required by child, 294 
POSITION 
correct, when sitting, 55 
when standing, 55 
when walking, 55 

POTATO AS FOOD, 80 
how to cook, 80 

POULTICE 
hot flaxseed, for abdominal pain, 352 
mustard, how prepared, 343 

POWDER 

for itching, 357 

how to give to child, 319 
POWDERS 

face, 42 

PREGNANCY 

abdomen during, 154 

artificial termination of. a cause of 

women's diseases, 384, 385 
bathing during, 163 
care of breasts during. 165 



462 



INDEX. 



Pregnancy— continued 
care of discharges during, 166 

of excretions during, 166 
changes in mother during, 154 
determination of the existence of, 156 
diet during, 161, 162 
dress during, 162 
duration of, 186 
exercise during, 164 
marital relations during, 166 
maternal impressions during, 165, 166 
normal termination of, 185 
physiology of, 150, 153 
rest during, 164 
sleep during, 164 
symptoms of, 154, 156 
uterus during, 154 

PREVENTION 
of acute inflammation of womb, 390 
cancer, 389, 391 

displacements of womb, 390-391 
better than cure, 388 
by personal purity, 392 
knowledge of causes of women's dis- 
eases necessary to, 389 
of tuberculosis, 389 

PRIVY 

disinfection of, 333 
PROPORTION 

definition of, 27 

PROTEID 

decreasing, in cow's milk, 243 
difference of digestibility of, in human 

and cow's milk, 244 
how to mere- e, in human milk, 232 
modification of, in cow's milk, 243 
percentage of, in cow's milk, 243 
in human milk, 230, 231 

PRURITIS 
causes of, 356 
definition of, 356 
powder for, 357 
treatment of, 356, 357 

PUBERTY 
(See Adolescence.) 
age of, in girls, 100 
changes at, ioo 
delay in appearance of, 101 
disregard of, at school, 352 
hygiene of, 105 
mental changes at, 102 
mother's duty at time of, 103, 104 



religious changes at, 102, 103 
variations in age of, 100 

PUERPERAL INFECTION 
description of, 198, 199 
how prevented, 200, 209 
how produced, 199 
result of, 200 

PUERPERIUM 
attention to bowels during, 213 

to urine during, 213 
bathing during, 212 
cleanliness during, 210 
definition of, 193 
diet during, 211 
getting up during, 210 
imprudence during, a cause of wom- 
en's diseases, 384 
life during, 211 
position in bed during, 210 
quiet during, 210 
rest during, 210 

results of imprudence during, 384 
urination during, 212 
visitors during, 211 

"PULLER" 

use of, during labor, 203 

PUNCHING THE BAG 
as an exercise, 90 

PUNISHMENTS 
in training of child, 297, 298 
nature of, to be considered, 298 
when to employ, 298 

PURITY 
danger of silence concerning, ill 
definition of, 112 
hygiene in relation to, 115 
mother's duty in regard to, 112 
responsibility concerning, in 
personal, a preventive of disease, 392 
proper instruction concerning, 112 

"QUACKS" 
avoidance of, 375 

QUARANTINE 
definition of, 333 
establishment of, 333 
for small-pox, 333 
how long maintained, 333 

QUESTIONING 
of children, 294 



INDEX. 



463 



QUICKENING 
explanation of, 159 
occurrence of, in pregnancy, 158 

RACE SUICIDE 

Roosevelt on, 147-149 
RECREATION 

different kinds of, 86 

forms of mental, 87 
of physical, 88, 89, 90 

kinds of, required, 87 

mental, 87 

necessity for, 86 

physical, 87 

RED 

hair in relation to dress, 68 
RELAX 
ability to, 84 

REPRODUCTION 
cells concerned in, 151 
common to all living matter, 93 
in animals, 152 

birds, 94 

fish, 94 

flowers, 152 

higher forms of life, 93, 94 

human beings, 152 

plants, 94 
various methods of, 151 

REPRODUCTIVE ORGANS 
in birds, 94 
fish, 94 

higher animals, 95 
plants, 94 
woman, 96-99 

REST 

during puerperium, 210 
in intestinal disorders of infant, 342 
mid-day, 85 
necessity for, 84 
want of sufficient, a cause of women's 

diseases, 380 
weekly, 85 
yearly, 85 

ROOM 
airing, after disinfection, 333 
cleansing, after disinfection, 333 
disinfection of, 330 
methods of disinfecting, 331 
sealing, for disinfection, 333 
sick-room (see Sick-Room ). 



ROOTS 

as food, 80 
RUBELLA 

nature of, 324 

RUNNING 

as an exercise, 88 
SAGO 

as a food, 80 
SCALING, 329 
SCALP 

massage of, 48 

SCARLET FEVER 

danger during scaling from, 329 

description of, 324 

greasing body during scaling from, 329 

SCHOOL 
a factor in producing deformities, 53 
age at which child should commence, 

303 

health of child little regarded at, 381 

hygiene of, 303 

medical inspection of, 303 

no special attention at, at time of 
puberty, 382 

no special care at, at menstrual period, 
382 

proper length of session of, 303 

question of sex disregarded at, 382 

special, for backward children, 303 
for mentally deficient children, 303 

too severe courses at, a cause of dis- 
eases of women, 381 

work not regulated at, in accordance 
with health, 381 

SEAT-WORMS 
a cause of itching, 356 
a cause of leucorrhea, 354 

SECRET VICE 
a cause of sterility, 374 
danger of, 114 

hygiene as preventive and treatment 
of, 115 

SELF -ABUSE 
(See Secret Vice.) 
a cause of sterility, 374 

SENSITIVENESS 
of child, 293 



464 INDEX. 

SEPSIS 
definition of, 199 
puerperal, 199 

SEX 
disregard of, at school, 382 
in birds, 94 

fish, 94 

flowers, 94 

plants, 94 
throughout nature, 93 

SHEET 

over doorway of sick room, 326 
SHELL-FISH AS FOOD, 78 
SHIRT, 

infant's, 268 
SHOES 

for baby, 271 
child, 272 

proper shape of, 67 

SHOW, 197, 198 

SICK-ROOM 
airing of, after disinfection, 331 
articles needed in, 313 
bed in, 313 
cleansing, 314 
disinfection of, 330 
for isolation, 326 
heating, 312, 313 
how to disinfect, 331 
in contagious diseases, 326 
position of, 311 
preparation of, 311 
preparation of, for contagious diseases, 

326 
sealing of, for disinfection, 331 
selection of, 311 
sheet over doorway of, 326 
ventilation of, 311 
vessels in, for disinfecting linen, 326 

SIT 

how to sit properly, 56 

SKIN 
appearance of infant's, 219 
color of infant's, 219, 220 
disinfection of, in contagious disease, 

329 
greasing, during scaling, 329 
layers of, 33 
outer, 34 



structure of, 33 
true, 34 

SKIRTS 

how to suspend, 66 
SLEEP 

amount of, required for adults, 85 
required for baby, 276, 277 

baby should sleep alone, 278 

baby's position during, 276 

children should be undisturbed in, 277 

fresh air during, 86 

how to promote, 86 

how to put baby to, 375 

position during, 85, 86 

regularity in hours of, 375 

required by baby, 274 

rules concerning, 86 

time for babies', 276 

SMALL-POX 
absolutely prevented by vaccination, 333 
easily prevented, 325, 333 
quarantine for, S33 

SOAP 

use of, on the face, 41 

SOCKS 

for baby, 269 
SODA 

Boiling solution of, for disinfecting 
bowel evacuations, 338 
for disinfecting sputum, 338 
solution for wiping woodwork after 
disinfection, 331 

SODA MINT 
dose of, 343 
for colic of baby, 343 
for vomiting of baby, 343 
how given, 343 

SOOTHING SYRUP 

always contains opium, 343 

dangerous to baby, 343 

responsible for many infant deaths, 34$ 

SPICE PLASTER 
how prepared, 342, 343 
in vomiting of baby, 342, 343 

SPITTLE 

(See Sputum.) 

SPOILING 
child, 296, 297 



INDEX. 



46: 



SPUTUM 
care of, 327 
cup for, 336, 338, 339 
flask for, 339 
receptacle for, 327 

STAINS 

how to remove, 314 
STAND 

how to stand properly, 55 
STERILE 

(See Aseptic.) 
STERILIZER 

Arnold steam, 348 
STERILITY 
caused by alcoholism, 374 

disease of fallopian tubes, 374 

disease of ovaries, 374 

displacement of womb, 373 

gonorrhea, 374 

great obesity, 374 

inflammation of womb, 374 

lack of affinity, 374 

lack of moderation, 374 

leucorrhea, 374 

modern system of education, 382 

self-abuse, 374 

unrepaired lacerations, 373 

unrepaired tears, 373 
causes of, 373, 374 
cure of, 375, 376 
description of, 373 
fault in, 373 
frequency of, 373 
necessity for examination of husband 

in, 375 
prevention of, 375 

STERILIZATION 
of hands, 201 
dressings, etc., before labor, 177 
instruments, 201 
milk, 248 

when necessary, 247 
when unnecessary, 247 

STOCKINGS 
for baby, 270 

STORIES 

told to children, 300 
SUGAR 

chief value of, 79 

of commerce, 79 



how to be eaten, 79 

percentage of, in cow's milk, 243 
in human milk, 230, 231 
SUICIDE 

race, 147, 149 
SULPHUR 

amount of, required for disinfecting, 
330 

for disinfecting room, 330 

method of disinfecting with, 331 

of little value for disinfecting room, 
330 
SUSPENDERS 

for skirts, 66 

use of, during pregnancy, 163 

SWIMMING 

as an exercise, 89 
SYMMETRY 

definition of, 27 

SYMPTOMS 

how to observe, 347 

of miscarriage, 368, 369 

of women's diseases, 347 

temporary treatment of, in women's 
diseases, 347 

that are danger signals. 350 

women must not be on lookout for. 348 
SYPHILIS 

a cause of leucorrhea, 354 

marriage of syphilitics, 138 
SYRINGE 

use of, in giving enema, 321 
T -BAND AGE 

how applied, 371 

how made, 370 

TAPIOCA AS A FOOD, 80 
TALK 

learning to, 298 
TEA AS A BEVERAGE, 81, 82 
TEAR 

(See Laceration.) 

of neck of womb a cause <~>f leucor- 
rhea,. 3S4 
TEETH 

brush for, 45 

care of, 44 

cleansing, 45 

cleansing baby's. 264 

cutting, 222, 223 

how to brush, 45 



4 66 



INDEX. 



Teeth — continued 
milk, 222 

names of, 222, 223 
permanent, 223 
powder for, 45 
second, 222, 223 
temporary, 222 
time of appearance of, 222, 223 

TEETHING 

a normal process, 223 
TEMPER 

of children, 295 

TEMPERATURE 
different methods of taking, 308 
how to take, 308 
of baby, 307 
of children, 308 

of sick-room to be tested by ther- 
mometer, 312 
taken by axilla, 309 

by month, 308 

by rectum, 309 

TETHER TENNIS 

as an exercise, 89 
THERMOMETER 

bath, 263 

clinical, 308 

how to shake down, 308 

should be used in testing temperature 
of sick-room, 312 

THREAD WORMS 
(See Seat Worms.) 

THREATS 
in training of child, 207 

TOE 
toe-rising exercise, 61 

TOILET 
of the face, 41 
sick baby, 315 
sick child, 315 

TONGUE 

of an infant, 307 
TOOTH 

powder, 45 

brush, 45 

TOWELS 
disinfection of, in contagious diseases, 
327 



TRAINING 

child in control of bladder and bowels, 
293 

in use of money, 299 
early, importance of, 292 
firmness in training child, 296 
habits of order and neatness in child, 

298 
in cooking, 128 
in marketing, 127, 128 
mental, 127 

of children, 295 
of backward children, 303 
mentally deficient children, 303 
of deficient children at home, 303, 304 

in special school, 303, 304 
practice versus precept in, 294, 295 
punishment of child in, 297, 298 
threatening child in, 297 

TREATMENT 
after-treatment of abortion, 371, 372 

of miscarriage, 371, 372 
of absence of menstruation, 363 
constipation, 357 
inevitable abortion, 371 
sudden checking of menstrual flow, 

364 
threatened abortion, 370, 371 

miscarriage, 370, 371 
vicarious menstruation, 364 

TRUTH 
instructing child in, 295 

TUB 
for baby, 262, 263 

TUBERCULOSIS 
(See Consumption.) 
bathing of patient with, 340 
care of patient with, 339, 340 

sputum in, 338, 339 
diet of patient with, 340 
exercise of patient with, 340 
heredity sometimes a factor in, 137 
how acquired, 137 
life of person with, 339, 340 
marriage and, 137 
those liable to, 137 
treatment of patient with, 340 

TUBERS 
as food, 79 

TUMOR 
a cause of sterility, 373 



INDEX. 



467 



TURNIPS AS FOOD, 80 
TWISTING EXERCISES, 61 
TYPES OF BEAUTY, 69 
TYPHOID FEVER 
care of patient with, 338 
disinfection of hands after attending 

to patient with, 338 
disinfection of linen, dishes, etc., in, 

338 
how communicated, 337 
how carried, 337, 338 
prompt disinfection of all discharges 
in, 338 

UMBILICAL CORD 

cutting of, 205 

drying up of, 224 

formation of, 153 

separation of, 224 

tying of, 205 
UNDERWEAR 

child's, 272 

material for, 65 

unsuitable, 378 

URINATION 

attention to, in contagious diseases, 327 
during puerperium, 212, 213 
in sick child, 322 / 

difficulty of, after child-birth, 194 

methods to excite, 322 

of baby, 226 

training child in control of, 293 
URINE 

disinfection of, 327 
UTERUS 

anatomy of, 96 

description of, 96 

inflammation of, a cause of sterility, 
374 
VACATION 

necessity for, 85 

weekly, 85 

yearly, 85 
VACCINATION 

an absolute preventive of small pox, 

333 
at what age it should be per forme d, 334 
best, time for, 334 
discussion of, 333 
dressing after, 335 

how often it should be performed. 334 
little danger if properly performed. 3J4 



method of, 335 
protection of part after, 335 
shields not desirable after, 335 
when it should be performed, 334 

VAGINA 
anatomy of, 97 
bloody discharge from, 356 
description of, 97 
discharge from, 354 
douche for, 353 
white discharge from, caused by : 

consumption, 354 

displacement of womb, 354 

general ill-health, 354 

gonorrhea, 354 

seat-worms, 354 

syphilis, 354 

tear of neck of womb, 354 
yellow discharge from, 355 
VEGETABLES^ 79 
green, as food, 81 
VENUS DE MEDICI, 52 
VERNIX CASEOSA 
character of, 219 
removal of, 262 

VESSELS 

disinfection of, in contagious diseases, 
327 
VICARIOUS MENSTRUATION 

treatment of, 364 
VICE 

dangers of secret, 114 

hygiene as preventive of secret, 115 

VISITORS 
after labor, 211 
during puerperium, 21 1 

VOMITING 

distinguished from simple regurgita- 
tion, 340 

in all acute diseases of children. 340 

mustard plaster for vomiting of baby, 
343 

mustard poultice for vomiting of baby 

343 
of pregnancy, 157 

soda mint for vomiting of baby. 343 
spice plaster for vomiting of baby, 343 

VULVA 
itching of. 3^6 

(See Pruritis.) 



468 



INDEX. 



WAIST 

Ferris maternity, 163 
for suspending skirt, 66 
hygienic, for pregnant women, 163 
Jenness-Miller, 163 
WALKING 
as an exercise, 88 
proper method of, 57 

WASH 
for mouth, 45 

WASHING 
the face, 41 

WASTING 

in intestinal disorders of infancy, 341 
WATER 

at meals, 81 

daily amount required, 81 

for drinking, 81 

"THE WATERS" 
(See Liquor Amnii.) 

WEANING 
best age for, 240 
best time of year for, 240 
care of mother during, 240 
conditions in the mother necessitating, 

239 

gradual, 239 

indications for, 238, 239 

methods of, 239 

rapid, 240 

time for, 240 

wet nurse preferred to, 236 

WEIGHING AN INFANT, 225 

WEIGHT 

less of, in an infant, 226 

of an infant, 224, 225 

WET-NURSE 
advantage of, 236 
choice of, 237 
disadvantages of, 236 
instead of weaning, 236 
moral character of, considered, 237, 238 
necessity for. 236 

personal qualities required in, 237 
physical conditions required in, 237 
requirements in, 237 
rules to be observed by, 23S 

WHEY 

as a substitute for mother's milk, 242 



"WHITES" 

(See Leucorrhea.) 
WHOOP 
character of, 336 . 

WHOOPING-COUGH 
deaths from, 336 
fresh air in treatment of, 336 
management of child with, 336 
more serious than generally supposed, 

336 
paroxysmal stage of, 336 
symptoms of, 2>Z^> 
whoop of, 336 

WIFE 
character of, dwarfed by humiliation, 

145, I4<3 
dresses for world rather than for the 

house, 142 
economic dependence of, 145 
neglects home for world, 143 

husband for world, 142 
qualities needed by working-man's 

wife, 126 
respect due a good, 148 
training of a girl for, 126 

WOMAN 
diseases of, caused by: 
artificial termination of pregnancy, 

.384, 385 
chronic constipation, 385 
improper food, 380 
improprieties of dress, 378-380 
imprudence during menstruation, 383 
lack of proper exercise, 378 
mismanagement during childbirth, 
383 
after childbirth, 383 
neglect of hygienic rules, 378 
unhygienic marital relations, 385 
want of sufficient rest, 380 
has no inherent tendency to diseases, 

385 
majority of causes of diseases of. -Dre- 

ventable, 385, 386 ^ 
must follow physician's directions, 38S 
must put herself under physician's care 

when sick, 387, 388 
S3'mptoms of diseases of, 347 
treatment of symptoms of diseases of, 
347 
WOMB 
(See Uterus.) 



INDEX. 46g 

WOOL WORMS 

best material for underwear, 65 seat, a cause of itching, 356 

good absorbent of moisture, 65 a cause of leucorrhea, 354 

poor heat-conductor, 65 WRAPS 

WORK for baby, 269 

in its relation to health, 83 WRINKLES 

WORKING DAY prevention of, 43 

length of, 84 removal of, 43 



INDEX TO CHAPTER XXXIX. 

Accidents and Emergencies. 

PAGE 

Accidents and Emergencies 393 

Arrest of Hemorrhage 407 

Burns and Scalds 398 

Chilblain 403 

Contusion or Bruises 406 

Dislocations 413 

Drowning 417 

Emetics 416 

Foreign Bodies : 

Ear 395 

Eye 393 

Nose 306 

Throat 397 

Fractures 4 1 4 

Frost-Bite 402 

Heat Exhaustion 40 1 

Mad Dog. Bite of a 412 

Poisons, Action of 4*6 

Shock, Condition of 405 

Snake Bites 411 

Sprains 4 l 3 

Stings : Bees, Wasps, Hornets \i 1 

Sunstroke or Heatstroke 400 

Wounds 407 



r n WW 



